- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,953.59 / $5,128.00 / $20,680.40
| Facility | | $1,953.59 | $5,128.00 | $20,680.40 |
- 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
- $1,720.74 / $2,970.17 / $11,234.92
| Facility | | $1,720.74 | $2,970.17 | $11,234.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,945.27 / $2,621.71 / $2,767.60
| Facility | | $1,945.27 | $2,621.71 | $2,767.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,843.71 / $1,854.51 / $2,513.62
| Facility | | $1,843.71 | $1,854.51 | $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
- $2,912.00 / $3,509.00 / $17,644.00
| Facility | | $2,912.00 | $3,509.00 | $17,644.00 |