- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,053.02 / $10,122.46 / $20,987.47
| Facility | | $2,053.02 | $10,122.46 | $20,987.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,866.94 / $16,595.73 / $31,745.76
| Facility | | $9,866.94 | $16,595.73 | $31,745.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,147.74 / $4,147.74 / $6,910.09
| Facility | | $4,147.74 | $4,147.74 | $6,910.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,771.60 / $2,986.31 / $11,234.92
| Facility | | $1,771.60 | $2,986.31 | $11,234.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,930.10 / $2,624.39 / $2,934.60
| Facility | | $1,930.10 | $2,624.39 | $2,934.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,983.23 / $2,001.66 / $2,513.62
| Facility | | $1,983.23 | $2,001.66 | $2,513.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,761.59 / $16,586.25 / $31,745.76
| Facility | | $10,761.59 | $16,586.25 | $31,745.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,312.00 / $21,157.82 / $33,842.43
| Facility | | $10,312.00 | $21,157.82 | $33,842.43 |