- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,432.91 / $2,769.52 / $18,711.00
| Facility | | $1,432.91 | $2,769.52 | $18,711.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,562.96 / $14,655.16 / $28,049.69
| Facility | | $8,562.96 | $14,655.16 | $28,049.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,586.64 / $4,586.64 / $7,641.31
| Facility | | $4,586.64 | $4,586.64 | $7,641.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $970.51 / $1,772.96 / $8,210.75
| Facility | | $970.51 | $1,772.96 | $8,210.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,094.49 / $1,513.53 / $1,576.51
| Facility | | $1,094.49 | $1,513.53 | $1,576.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.45 / $1,075.32 / $2,850.78
| Facility | | $1,041.45 | $1,075.32 | $2,850.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,508.65 / $14,655.16 / $28,049.69
| Facility | | $9,508.65 | $14,655.16 | $28,049.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,198.00 / $18,181.98 / $29,082.50
| Facility | | $7,198.00 | $18,181.98 | $29,082.50 |