- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,486.75 / $4,792.00 / $10,686.00
| Facility | | $1,486.75 | $4,792.00 | $10,686.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,079.00 / $7,264.00 / $12,538.00
| Facility | | $4,079.00 | $7,264.00 | $12,538.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,667.21 / $1,667.21 / $8,917.50
| Facility | | $1,667.21 | $1,667.21 | $8,917.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.10 / $1,348.10 / $13,296.25
| Facility | | $1,348.10 | $1,348.10 | $13,296.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.00 / $1,961.43 / $3,438.40
| Facility | | $319.00 | $1,961.43 | $3,438.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $1,348.10 / $74,999.25
| Facility | | $555.00 | $1,348.10 | $74,999.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,444.00 / $6,700.00 / $16,403.00
| Facility | | $2,444.00 | $6,700.00 | $16,403.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,467.63 / $1,467.63 / $3,987.42
| Facility | | $1,467.63 | $1,467.63 | $3,987.42 |