- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,475.84 / $4,718.43 / $20,680.40
| Facility | | $2,475.84 | $4,718.43 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,481.98 / $2,800.00 / $25,503.84
| Facility | | $2,481.98 | $2,800.00 | $25,503.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $714.97 / $947.00
| Facility | | $500.00 | $714.97 | $947.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,733.21 / $3,588.15 / $4,615.92
| Facility | | $1,733.21 | $3,588.15 | $4,615.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,635.22 / $3,533.11 / $3,707.78
| Facility | | $2,635.22 | $3,533.11 | $3,707.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,481.98 / $2,481.98 / $2,529.04
| Facility | | $2,481.98 | $2,481.98 | $2,529.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,245.00 / $22,245.00 / $22,245.00
| Facility | | $22,245.00 | $22,245.00 | $22,245.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,900.00 / $4,686.00 / $19,271.00
| Facility | | $1,900.00 | $4,686.00 | $19,271.00 |