- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,307.25 / $3,915.90 / $17,930.00
| Facility | | $1,307.25 | $3,915.90 | $17,930.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,412.56 / $16,394.00 / $21,924.91
| Facility | | $3,412.56 | $16,394.00 | $21,924.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.25 / $761.81 / $6,910.09
| Facility | | $625.25 | $761.81 | $6,910.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $907.87 / $1,753.90 / $6,320.69
| Facility | | $907.87 | $1,753.90 | $6,320.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,167.92 / $1,535.64 / $1,625.20
| Facility | | $1,167.92 | $1,535.64 | $1,625.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,082.22 / $1,994.21 / $3,953.90
| Facility | | $1,082.22 | $1,994.21 | $3,953.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,761.59 / $16,595.73 / $31,745.76
| Facility | | $10,761.59 | $16,595.73 | $31,745.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,100.00 / $2,038.00 / $10,522.00
| Facility | | $1,100.00 | $2,038.00 | $10,522.00 |