- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.40 / $5,116.62 / $21,917.86
| Facility | | $1,506.40 | $5,116.62 | $21,917.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,500.00 / $37,275.87 / $50,401.30
| Facility | | $11,500.00 | $37,275.87 | $50,401.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $883.20 / $1,075.31 / $15,711.66
| Facility | | $883.20 | $1,075.31 | $15,711.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,181.00 / $2,400.56 / $13,778.60
| Facility | | $1,181.00 | $2,400.56 | $13,778.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,570.45 / $2,141.32 / $2,267.28
| Facility | | $1,570.45 | $2,141.32 | $2,267.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,502.60 / $1,546.49 / $17,043.99
| Facility | | $1,502.60 | $1,546.49 | $17,043.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,749.60 / $37,275.87 / $71,345.31
| Facility | | $24,749.60 | $37,275.87 | $71,345.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $5,547.00 / $19,271.00
| Facility | | $3,028.00 | $5,547.00 | $19,271.00 |