- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,833.49 / $4,392.00 / $10,296.00
| Facility | | $1,833.49 | $4,392.00 | $10,296.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,100.00 / $7,264.00 / $12,697.00
| Facility | | $4,100.00 | $7,264.00 | $12,697.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,228.07 / $3,228.07 / $37,499.62
| Facility | | $3,228.07 | $3,228.07 | $37,499.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,606.04 / $2,606.04 / $7,227.90
| Facility | | $2,606.04 | $2,606.04 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.00 / $2,655.00 / $5,848.40
| Facility | | $319.00 | $2,655.00 | $5,848.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $2,606.04 / $7,227.90
| Facility | | $555.00 | $2,606.04 | $7,227.90 |
- 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
- $2,950.06 / $2,950.06 / $7,965.27
| Facility | | $2,950.06 | $2,950.06 | $7,965.27 |