- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,038.56 / $5,128.00 / $21,917.86
| Facility | | $1,038.56 | $5,128.00 | $21,917.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,961.46 / $9,172.83 / $20,286.13
| Facility | | $2,961.46 | $9,172.83 | $20,286.13 |
- 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
- $583.77 / $1,183.17 / $3,280.24
| Facility | | $583.77 | $1,183.17 | $3,280.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $769.79 / $1,054.58 / $1,134.98
| Facility | | $769.79 | $1,054.58 | $1,134.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $749.26 / $774.16 / $2,961.46
| Facility | | $749.26 | $774.16 | $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 |