- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $5,754.40 / $12,882.50
| Facility | | $1,819.70 | $5,754.40 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $8,511.38 / $16,595.87
| Facility | | $4,466.84 | $8,511.38 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $4,265.80 / $16,595.87
| Facility | | $1,949.84 | $4,265.80 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $3,311.31 / $50,118.72
| Facility | | $2,344.23 | $3,311.31 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,818.38 / $2,818.38 / $2,818.38
| Facility | 22 | $2,818.38 | $2,818.38 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $2,344.23 / $4,786.30
| Facility | | $1,445.44 | $2,344.23 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $50,118.72 / $75,857.76
| Facility | | $1,513.56 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $6,606.93 / $18,620.87
| Facility | | $2,511.89 | $6,606.93 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,778.28 / $4,786.30
| Facility | | $1,122.02 | $1,778.28 | $4,786.30 |