- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,054.56 / $5,128.00 / $20,680.40
| Facility | | $1,054.56 | $5,128.00 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,961.46 / $9,172.83 / $20,286.13
| Facility | | $2,961.46 | $9,172.83 | $20,286.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $870.49 / $3,740.43
| Facility | | $714.97 | $870.49 | $3,740.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $620.22 / $1,254.32 / $3,280.24
| Facility | | $620.22 | $1,254.32 | $3,280.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $807.18 / $1,110.19 / $1,165.13
| Facility | | $807.18 | $1,110.19 | $1,165.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $777.80 / $794.72 / $2,961.46
| Facility | | $777.80 | $794.72 | $2,961.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,948.17 / $9,167.59 / $17,546.59
| Facility | | $5,948.17 | $9,167.59 | $17,546.59 |
- 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 |