- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,022.63 / $5,128.00 / $20,680.40
| Facility | | $1,022.63 | $5,128.00 | $20,680.40 |
- 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
- $714.97 / $870.49 / $3,740.43
| Facility | | $714.97 | $870.49 | $3,740.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $558.10 / $1,151.01 / $3,280.24
| Facility | | $558.10 | $1,151.01 | $3,280.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $738.05 / $1,026.91 / $1,166.47
| Facility | | $738.05 | $1,026.91 | $1,166.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $788.67 / $795.64 / $2,961.46
| Facility | | $788.67 | $795.64 | $2,961.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,948.17 / $9,167.59 / $17,546.59
| Facility | | $5,948.17 | $9,167.59 | $17,546.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $702.00 / $1,436.00 / $6,857.00
| Facility | | $702.00 | $1,436.00 | $6,857.00 |