- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,134.67 / $2,154.71 / $20,680.40
| Facility | | $1,134.67 | $2,154.71 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.71 / $16,547.20 / $31,745.76
| Facility | | $1,096.71 | $16,547.20 | $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
- $977.82 / $1,640.03 / $6,447.65
| Facility | | $977.82 | $1,640.03 | $6,447.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,048.94 / $1,461.94 / $1,631.45
| Facility | | $1,048.94 | $1,461.94 | $1,631.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.71 / $1,112.80 / $2,513.62
| Facility | | $1,096.71 | $1,112.80 | $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
- $1,550.00 / $2,431.00 / $11,261.00
| Facility | | $1,550.00 | $2,431.00 | $11,261.00 |