- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,525.47 / $5,128.00 / $20,680.40
| Facility | | $1,525.47 | $5,128.00 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,961.22 / $10,166.93 / $19,848.13
| Facility | | $1,961.22 | $10,166.93 | $19,848.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $796.68 / $1,285.00 / $4,636.17
| Facility | | $796.68 | $1,285.00 | $4,636.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.91 / $2,379.98 / $4,240.71
| Facility | | $1,506.91 | $2,379.98 | $4,240.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,631.31 / $2,255.89 / $2,371.16
| Facility | | $1,631.31 | $2,255.89 | $2,371.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,313.10 / $1,613.21 / $1,961.22
| Facility | | $1,313.10 | $1,613.21 | $1,961.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,832.97 / $10,161.12 / $19,448.18
| Facility | | $6,832.97 | $10,161.12 | $19,448.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,403.00 / $2,428.00 / $11,941.00
| Facility | | $1,403.00 | $2,428.00 | $11,941.00 |