- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,181.60 / $2,155.02 / $19,863.38
| Facility | | $1,181.60 | $2,155.02 | $19,863.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,462.32 / $16,394.00 / $31,745.76
| Facility | | $4,462.32 | $16,394.00 | $31,745.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,147.74 / $4,147.74 / $6,910.09
| Facility | | $4,147.74 | $4,147.74 | $6,910.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $807.54 / $1,482.40 / $5,194.27
| Facility | | $807.54 | $1,482.40 | $5,194.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $981.54 / $1,557.75 / $1,746.69
| Facility | | $981.54 | $1,557.75 | $1,746.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,171.01 / $1,191.40 / $2,513.62
| Facility | | $1,171.01 | $1,191.40 | $2,513.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,761.59 / $16,586.25 / $31,745.76
| Facility | | $10,761.59 | $16,586.25 | $31,745.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $2,431.00 / $11,261.00
| Facility | | $1,550.00 | $2,431.00 | $11,261.00 |