- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,608.73 / $4,441.00 / $10,170.00
| Facility | | $1,608.73 | $4,441.00 | $10,170.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,283.00 / $5,160.00 / $11,809.00
| Facility | | $3,283.00 | $5,160.00 | $11,809.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,858.68 / $3,478.50 / $13,477.50
| Facility | | $1,858.68 | $3,478.50 | $13,477.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.18 / $1,513.18 / $13,296.25
| Facility | | $1,513.18 | $1,513.18 | $13,296.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.00 / $1,408.00 / $3,565.13
| Facility | | $332.00 | $1,408.00 | $3,565.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $1,513.18 / $13,296.25
| Facility | | $555.00 | $1,513.18 | $13,296.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,031.00 / $4,840.00 / $9,202.00
| Facility | | $2,031.00 | $4,840.00 | $9,202.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,578.02 / $1,578.02 / $3,626.16
| Facility | | $1,578.02 | $1,578.02 | $3,626.16 |