- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,264.98 / $5,128.00 / $20,680.40
| Facility | | $2,264.98 | $5,128.00 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,218.36 / $8,047.87 / $17,808.41
| Facility | | $2,218.36 | $8,047.87 | $17,808.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $870.49 / $2,846.84
| Facility | | $714.97 | $870.49 | $2,846.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,735.30 / $2,925.22 / $4,600.60
| Facility | | $1,735.30 | $2,925.22 | $4,600.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,534.90 / $3,505.44 / $3,642.12
| Facility | | $2,534.90 | $3,505.44 | $3,642.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $738.78 / $2,429.89 / $2,484.25
| Facility | | $738.78 | $2,429.89 | $2,484.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,221.67 / $8,047.87 / $15,403.47
| Facility | | $5,221.67 | $8,047.87 | $15,403.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,547.00 / $2,408.00 / $10,522.00
| Facility | | $1,547.00 | $2,408.00 | $10,522.00 |