- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,774.18 / $7,083.47 / $21,917.86
| Facility | | $3,774.18 | $7,083.47 | $21,917.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,000.00 / $19,823.93 / $38,781.51
| Facility | | $2,000.00 | $19,823.93 | $38,781.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $883.20 / $1,075.31 / $8,315.84
| Facility | | $883.20 | $1,075.31 | $8,315.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,973.66 / $5,932.58 / $8,522.41
| Facility | | $2,973.66 | $5,932.58 | $8,522.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,731.84 / $5,411.59 / $6,014.59
| Facility | | $3,731.84 | $5,411.59 | $6,014.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,173.66 / $4,014.94 / $6,526.97
| Facility | | $2,173.66 | $4,014.94 | $6,526.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,146.66 / $20,262.22 / $38,781.51
| Facility | | $13,146.66 | $20,262.22 | $38,781.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $5,547.00 / $19,271.00
| Facility | | $3,028.00 | $5,547.00 | $19,271.00 |