- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,249.08 / $5,128.00 / $20,680.40
| Facility | | $1,249.08 | $5,128.00 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,474.84 / $18,877.79 / $36,111.08
| Facility | | $7,474.84 | $18,877.79 | $36,111.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $870.49 / $10,186.60
| Facility | | $714.97 | $870.49 | $10,186.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.94 / $1,396.99 / $8,933.32
| Facility | | $672.94 | $1,396.99 | $8,933.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $937.99 / $1,306.07 / $1,404.99
| Facility | | $937.99 | $1,306.07 | $1,404.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.63 / $958.33 / $7,474.84
| Facility | | $933.63 | $958.33 | $7,474.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,241.40 / $18,867.00 / $36,111.08
| Facility | | $12,241.40 | $18,867.00 | $36,111.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $4,016.00 / $16,315.00
| Facility | | $2,912.00 | $4,016.00 | $16,315.00 |