- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,358.47 / $5,128.00 / $21,917.86
| Facility | | $1,358.47 | $5,128.00 | $21,917.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,961.46 / $9,522.34 / $20,286.13
| Facility | | $2,961.46 | $9,522.34 | $20,286.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $883.20 / $1,075.31 / $4,864.17
| Facility | | $883.20 | $1,075.31 | $4,864.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $731.23 / $1,515.46 / $4,265.72
| Facility | | $731.23 | $1,515.46 | $4,265.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $964.16 / $1,333.30 / $1,498.12
| Facility | | $964.16 | $1,333.30 | $1,498.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $986.25 / $1,003.85 / $2,961.46
| Facility | | $986.25 | $1,003.85 | $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 |