- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,665.27 / $6,470.00 / $21,917.86
| Facility | | $1,665.27 | $6,470.00 | $21,917.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.33 / $6,858.44 / $14,605.02
| Facility | | $1,500.33 | $6,858.44 | $14,605.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $906.00 / $906.00 / $2,876.24
| Facility | | $906.00 | $906.00 | $2,876.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,249.05 / $1,533.97 / $2,947.69
| Facility | | $1,249.05 | $1,533.97 | $2,947.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,511.07 / $2,052.88 / $2,199.61
| Facility | | $1,511.07 | $2,052.88 | $2,199.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,126.18 / $1,457.30 / $1,500.33
| Facility | | $1,126.18 | $1,457.30 | $1,500.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,282.39 / $6,600.21 / $12,632.68
| Facility | | $4,282.39 | $6,600.21 | $12,632.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,220.00 / $2,136.00 / $10,522.00
| Facility | | $1,220.00 | $2,136.00 | $10,522.00 |