- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,010.69 / $6,470.00 / $21,917.86
| Facility | | $1,010.69 | $6,470.00 | $21,917.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,031.87 / $11,522.14 / $25,481.74
| Facility | | $2,031.87 | $11,522.14 | $25,481.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $906.00 / $906.00 / $4,960.67
| Facility | | $906.00 | $906.00 | $4,960.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $786.72 / $1,619.34 / $4,350.34
| Facility | | $786.72 | $1,619.34 | $4,350.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $910.86 / $1,259.59 / $1,329.28
| Facility | | $910.86 | $1,259.59 | $1,329.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $877.01 / $877.01 / $906.69
| Facility | | $877.01 | $877.01 | $906.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,600.42 / $11,522.14 / $22,040.55
| Facility | | $7,600.42 | $11,522.14 | $22,040.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,224.00 / $1,862.00 / $10,522.00
| Facility | | $1,224.00 | $1,862.00 | $10,522.00 |