- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,143.80 / $2,271.10 / $18,711.00
| Facility | | $1,143.80 | $2,271.10 | $18,711.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,348.40 / $19,823.93 / $38,781.51
| Facility | | $3,348.40 | $19,823.93 | $38,781.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $870.49 / $11,926.94
| Facility | | $714.97 | $870.49 | $11,926.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $818.71 / $1,566.58 / $7,540.04
| Facility | | $818.71 | $1,566.58 | $7,540.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,135.64 / $1,668.30 / $1,814.36
| Facility | | $1,135.64 | $1,668.30 | $1,814.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,186.41 / $1,237.56 / $9,350.15
| Facility | | $1,186.41 | $1,237.56 | $9,350.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,146.66 / $20,262.22 / $38,781.51
| Facility | | $13,146.66 | $20,262.22 | $38,781.51 |
- 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 |