- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,015.06 / $5,576.00 / $12,424.00
| Facility | | $2,015.06 | $5,576.00 | $12,424.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,040.00 / $10,294.00 / $19,351.80
| Facility | | $5,040.00 | $10,294.00 | $19,351.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,569.67 / $2,569.67 / $18,749.82
| Facility | | $2,569.67 | $2,569.67 | $18,749.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,078.87 / $2,078.87 / $7,227.90
| Facility | | $2,078.87 | $2,078.87 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.00 / $2,315.33 / $47,618.00
| Facility | | $332.00 | $2,315.33 | $47,618.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $2,078.87 / $74,999.25
| Facility | | $555.00 | $2,078.87 | $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
- $2,262.10 / $2,262.10 / $2,913.55
| Facility | | $2,262.10 | $2,262.10 | $2,913.55 |