- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,454.54 / $9,350.64 / $17,930.00
| Facility | | $1,454.54 | $9,350.64 | $17,930.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,490.98 / $9,167.59 / $17,907.41
| Facility | | $5,490.98 | $9,167.59 | $17,907.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $883.20 / $1,075.31 / $3,740.43
| Facility | | $883.20 | $1,075.31 | $3,740.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $866.52 / $1,770.08 / $3,280.24
| Facility | | $866.52 | $1,770.08 | $3,280.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,170.11 / $1,603.31 / $1,711.18
| Facility | | $1,170.11 | $1,603.31 | $1,711.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $986.25 / $1,126.16 / $2,961.46
| Facility | | $986.25 | $1,126.16 | $2,961.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,013.44 / $9,167.59 / $17,546.59
| Facility | | $6,013.44 | $9,167.59 | $17,546.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,129.00 / $11,941.00
| Facility | | $2,155.00 | $3,129.00 | $11,941.00 |