- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $4,265.80 / $11,748.98
| Facility | | $1,148.15 | $4,265.80 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $5,888.44 / $13,489.63
| Facility | | $3,388.44 | $5,888.44 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,230.27 / $12,302.69
| Facility | | $1,230.27 | $1,230.27 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $4,786.30 / $77,624.71
| Facility | | $34.67 | $4,786.30 | $77,624.71 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,737.80 / $1,737.80 / $1,737.80
| Facility | 22 | $1,737.80 | $1,737.80 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,584.89 / $3,019.95
| Facility | | $933.25 | $1,584.89 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $50,118.72 / $75,857.76
| Facility | | $954.99 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $5,888.44 / $26,915.35
| Facility | | $2,398.83 | $5,888.44 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,548.82 / $4,265.80
| Facility | | $676.08 | $1,548.82 | $4,265.80 |