- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,165.38 / $7,394.00 / $18,800.00
| Facility | | $1,165.38 | $7,394.00 | $18,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $871.04 / $20,262.22 / $38,781.51
| Facility | | $871.04 | $20,262.22 | $38,781.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $870.49 / $11,529.44
| Facility | | $714.97 | $870.49 | $11,529.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $656.41 / $1,330.03 / $10,110.94
| Facility | | $656.41 | $1,330.03 | $10,110.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $881.02 / $1,197.96 / $1,277.02
| Facility | | $881.02 | $1,197.96 | $1,277.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $841.22 / $871.04 / $8,493.41
| Facility | | $841.22 | $871.04 | $8,493.41 |
- 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 |