- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,201.56 / $5,128.00 / $20,680.40
| Facility | | $1,201.56 | $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
- $653.37 / $1,348.17 / $3,280.24
| Facility | | $653.37 | $1,348.17 | $3,280.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $850.30 / $1,175.84 / $1,360.10
| Facility | | $850.30 | $1,175.84 | $1,360.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $916.42 / $927.71 / $2,961.46
| Facility | | $916.42 | $927.71 | $2,961.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,646.13 / $9,167.59 / $17,546.59
| Facility | | $5,646.13 | $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 |