- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $762.00 / $2,572.00 / $7,495.00
| Facility | | $762.00 | $2,572.00 | $7,495.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,734.91 / $7,275.80 / $14,454.58
| Facility | | $3,734.91 | $7,275.80 | $14,454.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $815.52 / $815.52 / $815.52
| Facility | | $815.52 | $815.52 | $815.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,187.68 / $4,187.68 / $4,187.68
| Facility | | $4,187.68 | $4,187.68 | $4,187.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,500.00 / $16,394.00 / $16,547.20
| Facility | | $11,500.00 | $16,394.00 | $16,547.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $841.22 / $1,103.49 / $1,914.00
| Facility | | $841.22 | $1,103.49 | $1,914.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $839.30 / $1,135.33 / $2,109.21
| Facility | | $839.30 | $1,135.33 | $2,109.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,314.00 / $7,600.00
| Facility | | $1,154.00 | $3,314.00 | $7,600.00 |