- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $945.00 / $3,682.00 / $12,281.00
| Facility | | $945.00 | $3,682.00 | $12,281.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,680.09 / $4,909.47 / $9,381.18
| Facility | | $2,680.09 | $4,909.47 | $9,381.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $729.80 / $729.80 / $762.82
| Facility | | $729.80 | $729.80 | $762.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,953.70 / $1,953.70 / $2,017.56
| Facility | | $1,953.70 | $1,953.70 | $2,017.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,001.70 / $26,542.00 / $26,542.00
| Facility | | $9,001.70 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $756.70 / $973.03 / $1,525.65
| Facility | | $756.70 | $973.03 | $1,525.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $756.70 / $999.22 / $1,651.11
| Facility | | $756.70 | $999.22 | $1,651.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,200.00 / $10,600.00
| Facility | | $1,634.00 | $4,200.00 | $10,600.00 |