- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $856.21 / $2,769.52 / $18,711.00
| Facility | | $856.21 | $2,769.52 | $18,711.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,403.52 / $5,750.27 / $12,000.00
| Facility | | $3,403.52 | $5,750.27 | $12,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,315.02 / $1,315.02 / $2,190.81
| Facility | | $1,315.02 | $1,315.02 | $2,190.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $507.42 / $1,013.74 / $2,003.94
| Facility | | $507.42 | $1,013.74 | $2,003.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.49 / $896.36 / $1,019.07
| Facility | | $625.49 | $896.36 | $1,019.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $667.72 / $695.10 / $848.85
| Facility | | $667.72 | $695.10 | $848.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.09 / $5,468.48 / $10,466.57
| Facility | | $3,548.09 | $5,468.48 | $10,466.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $3,905.54 / $10,522.00
| Facility | | $1,550.00 | $3,905.54 | $10,522.00 |