- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $803.00 / $4,028.00 / $13,694.00
| Facility | | $803.00 | $4,028.00 | $13,694.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,021.69 / $17,970.07 / $35,464.12
| Facility | | $10,021.69 | $17,970.07 | $35,464.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.97 / $426.97 / $426.97
| Facility | | $426.97 | $426.97 | $426.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,615.89 / $14,615.89 / $14,615.89
| Facility | | $14,615.89 | $14,615.89 | $14,615.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,131.00 / $26,542.00 / $57,753.25
| Facility | | $12,131.00 | $26,542.00 | $57,753.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $507.08 / $1,213.32 / $2,275.35
| Facility | | $507.08 | $1,213.32 | $2,275.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $507.08 / $1,256.51 / $2,323.56
| Facility | | $507.08 | $1,256.51 | $2,323.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,600.00 / $9,027.00 / $20,955.00
| Facility | | $4,600.00 | $9,027.00 | $20,955.00 |