- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,365.98 / $5,228.00 / $11,396.00
| Facility | | $2,365.98 | $5,228.00 | $11,396.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,989.00 / $9,750.00 / $16,411.00
| Facility | | $4,989.00 | $9,750.00 | $16,411.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,408.63 / $3,408.63 / $37,499.62
| Facility | | $3,408.63 | $3,408.63 | $37,499.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,751.86 / $2,751.86 / $7,227.90
| Facility | | $2,751.86 | $2,751.86 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.00 / $2,551.14 / $14,171.96
| Facility | | $332.00 | $2,551.14 | $14,171.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $2,751.86 / $74,999.25
| Facility | | $555.00 | $2,751.86 | $74,999.25 |
- 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
- $3,013.75 / $3,013.75 / $6,677.31
| Facility | | $3,013.75 | $3,013.75 | $6,677.31 |