- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,172.39 / $2,769.52 / $18,711.00
| Facility | | $1,172.39 | $2,769.52 | $18,711.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,562.96 / $14,302.50 / $28,049.69
| Facility | | $8,562.96 | $14,302.50 | $28,049.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,585.08 / $3,585.08 / $5,972.71
| Facility | | $3,585.08 | $3,585.08 | $5,972.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.22 / $1,451.12 / $8,210.75
| Facility | | $794.22 | $1,451.12 | $8,210.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $920.22 / $1,241.51 / $1,296.08
| Facility | | $920.22 | $1,241.51 | $1,296.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $853.45 / $880.18 / $2,173.03
| Facility | | $853.45 | $880.18 | $2,173.03 |
- 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
- $3,028.00 / $4,686.00 / $20,708.00
| Facility | | $3,028.00 | $4,686.00 | $20,708.00 |