- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,216.81 / $4,943.12 / $10,296.00
| Facility | | $2,216.81 | $4,943.12 | $10,296.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,568.00 / $7,578.00 / $14,193.00
| Facility | | $4,568.00 | $7,578.00 | $14,193.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,912.40 / $3,912.40 / $37,499.62
| Facility | | $3,912.40 | $3,912.40 | $37,499.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,158.15 / $3,158.15 / $7,227.90
| Facility | | $3,158.15 | $3,158.15 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.00 / $2,605.50 / $7,377.93
| Facility | | $319.00 | $2,605.50 | $7,377.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $3,158.15 / $7,227.90
| Facility | | $555.00 | $3,158.15 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,749.00 / $4,194.00 / $9,300.00
| Facility | | $1,749.00 | $4,194.00 | $9,300.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,948.16 / $2,948.16 / $7,547.58
| Facility | | $2,948.16 | $2,948.16 | $7,547.58 |