- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,800.57 / $6,470.00 / $20,680.40
| Facility | | $1,800.57 | $6,470.00 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,923.44 / $8,047.87 / $15,403.47
| Facility | | $1,923.44 | $8,047.87 | $15,403.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $870.49 / $2,846.84
| Facility | | $714.97 | $870.49 | $2,846.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,385.60 / $2,421.55 / $3,626.77
| Facility | | $1,385.60 | $2,421.55 | $3,626.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,006.31 / $2,774.47 / $2,891.72
| Facility | | $2,006.31 | $2,774.47 | $2,891.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $738.78 / $1,923.44 / $2,218.36
| Facility | | $738.78 | $1,923.44 | $2,218.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,221.67 / $8,047.87 / $15,403.47
| Facility | | $5,221.67 | $8,047.87 | $15,403.47 |
- 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 |