- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,141.53 / $5,228.00 / $11,996.00
| Facility | | $2,141.53 | $5,228.00 | $11,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,793.00 / $9,974.00 / $17,122.00
| Facility | | $4,793.00 | $9,974.00 | $17,122.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,030.25 / $3,030.25 / $37,499.62
| Facility | | $3,030.25 | $3,030.25 | $37,499.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,395.69 / $2,395.69 / $7,227.90
| Facility | | $2,395.69 | $2,395.69 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.00 / $3,521.11 / $5,664.00
| Facility | | $319.00 | $3,521.11 | $5,664.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.00 / $2,395.69 / $74,999.25
| Facility | | $597.00 | $2,395.69 | $74,999.25 |
- 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
- $2,455.63 / $2,455.63 / $8,676.50
| Facility | | $2,455.63 | $2,455.63 | $8,676.50 |