- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,027.10 / $3,354.00 / $18,800.00
| Facility | | $1,027.10 | $3,354.00 | $18,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,613.81 / $4,589.03 / $11,500.00
| Facility | | $1,613.81 | $4,589.03 | $11,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $870.49 / $1,985.59
| Facility | | $714.97 | $870.49 | $1,985.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $775.71 / $1,499.41 / $2,053.71
| Facility | | $775.71 | $1,499.41 | $2,053.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,113.38 / $1,539.66 / $1,626.09
| Facility | | $1,113.38 | $1,539.66 | $1,626.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.44 / $1,077.23 / $1,613.81
| Facility | | $537.44 | $1,077.23 | $1,613.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,953.48 / $4,552.03 / $8,712.50
| Facility | | $2,953.48 | $4,552.03 | $8,712.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.00 / $792.49 / $5,793.00
| Facility | | $157.00 | $792.49 | $5,793.00 |