- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,025.05 / $6,067.00 / $13,790.00
| Facility | | $2,025.05 | $6,067.00 | $13,790.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,584.00 / $8,170.00 / $16,174.00
| Facility | | $4,584.00 | $8,170.00 | $16,174.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,569.58 / $2,569.58 / $18,749.82
| Facility | | $2,569.58 | $2,569.58 | $18,749.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,055.07 / $2,055.07 / $7,227.90
| Facility | | $2,055.07 | $2,055.07 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.00 / $2,328.88 / $47,618.00
| Facility | | $332.00 | $2,328.88 | $47,618.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $2,055.07 / $74,999.25
| Facility | | $555.00 | $2,055.07 | $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
- $2,228.80 / $2,228.80 / $2,925.06
| Facility | | $2,228.80 | $2,228.80 | $2,925.06 |