- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,002.24 / $3,682.00 / $11,232.00
| Facility | | $1,002.24 | $3,682.00 | $11,232.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,997.44 / $7,227.29 / $14,309.06
| Facility | | $3,997.44 | $7,227.29 | $14,309.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $917.27 / $8,530.40 / $8,530.40
| Facility | | $917.27 | $8,530.40 | $8,530.40 |
- 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 / $26,542.00 / $26,542.00
| Facility | | $11,500.00 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,002.24 / $1,327.66 / $2,392.50
| Facility | | $1,002.24 | $1,327.66 | $2,392.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,002.24 / $1,353.37 / $2,728.44
| Facility | | $1,002.24 | $1,353.37 | $2,728.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,093.00 / $6,000.00 / $13,134.00
| Facility | | $2,093.00 | $6,000.00 | $13,134.00 |