- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,733.00 / $7,863.94 / $20,680.40
| Facility | | $1,733.00 | $7,863.94 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,487.08 / $6,858.44 / $14,605.02
| Facility | | $1,487.08 | $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
- $1,260.08 / $1,654.83 / $3,026.01
| Facility | | $1,260.08 | $1,654.83 | $3,026.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,502.43 / $2,077.67 / $2,258.10
| Facility | | $1,502.43 | $2,077.67 | $2,258.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,126.18 / $1,434.65 / $1,487.08
| Facility | | $1,126.18 | $1,434.65 | $1,487.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,818.83 / $6,600.21 / $12,632.68
| Facility | | $4,818.83 | $6,600.21 | $12,632.68 |
- 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 |