- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,733.00 / $5,128.00 / $21,917.86
| Facility | | $1,733.00 | $5,128.00 | $21,917.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,264.85 / $8,052.47 / $17,808.41
| Facility | | $3,264.85 | $8,052.47 | $17,808.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $883.20 / $1,075.31 / $2,846.84
| Facility | | $883.20 | $1,075.31 | $2,846.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,086.64 / $2,089.31 / $2,917.56
| Facility | | $1,086.64 | $2,089.31 | $2,917.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,464.12 / $2,007.99 / $2,102.46
| Facility | | $1,464.12 | $2,007.99 | $2,102.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $738.78 / $1,400.68 / $2,218.36
| Facility | | $738.78 | $1,400.68 | $2,218.36 |
- 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
- $702.00 / $1,436.00 / $6,857.00
| Facility | | $702.00 | $1,436.00 | $6,857.00 |