- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,040.77 / $6,885.77 / $22,024.00
| Facility | | $3,040.77 | $6,885.77 | $22,024.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,384.54 / $18,633.84 / $35,644.43
| Facility | | $3,384.54 | $18,633.84 | $35,644.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $765.00 / $870.49
| Facility | | $714.97 | $765.00 | $870.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,311.36 / $4,635.34 / $6,685.79
| Facility | | $2,311.36 | $4,635.34 | $6,685.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,448.19 / $4,690.60 / $4,962.02
| Facility | | $3,448.19 | $4,690.60 | $4,962.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,287.42 / $3,287.42 / $3,384.54
| Facility | | $3,287.42 | $3,287.42 | $3,384.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,233.34 / $18,633.84 / $35,644.43
| Facility | | $14,233.34 | $18,633.84 | $35,644.43 |
- 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 |