- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,028.83 / $4,233.10 / $10,296.00
| Facility | | $2,028.83 | $4,233.10 | $10,296.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,100.00 / $7,264.00 / $12,538.00
| Facility | | $4,100.00 | $7,264.00 | $12,538.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,637.04 / $2,637.04 / $37,499.62
| Facility | | $2,637.04 | $2,637.04 | $37,499.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,154.05 / $2,154.05 / $7,227.90
| Facility | | $2,154.05 | $2,154.05 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.00 / $2,361.00 / $5,006.43
| Facility | | $319.00 | $2,361.00 | $5,006.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $2,154.05 / $74,999.25
| Facility | | $555.00 | $2,154.05 | $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
- $2,342.67 / $2,342.67 / $6,903.95
| Facility | | $2,342.67 | $2,342.67 | $6,903.95 |