- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,016.34 / $2,008.70 / $17,100.00
| Facility | | $1,016.34 | $2,008.70 | $17,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,960.21 / $9,118.81 / $17,453.22
| Facility | | $3,960.21 | $9,118.81 | $17,453.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.25 / $761.81 / $3,302.92
| Facility | | $625.25 | $761.81 | $3,302.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $727.88 / $1,377.92 / $2,494.19
| Facility | | $727.88 | $1,377.92 | $2,494.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,045.40 / $1,463.95 / $1,561.77
| Facility | | $1,045.40 | $1,463.95 | $1,561.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $803.50 / $1,027.85 / $2,412.73
| Facility | | $803.50 | $1,027.85 | $2,412.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,916.52 / $9,101.25 / $17,453.22
| Facility | | $5,916.52 | $9,101.25 | $17,453.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,547.00 / $2,408.00 / $10,522.00
| Facility | | $1,547.00 | $2,408.00 | $10,522.00 |