- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,373.58 / $7,489.85 / $20,680.40
| Facility | | $1,373.58 | $7,489.85 | $20,680.40 |
- 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
- $734.00 / $734.00 / $4,960.67
| Facility | | $734.00 | $734.00 | $4,960.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $987.13 / $2,067.84 / $4,350.34
| Facility | | $987.13 | $2,067.84 | $4,350.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,142.45 / $1,591.20 / $1,806.32
| Facility | | $1,142.45 | $1,591.20 | $1,806.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,204.98 / $1,204.98 / $1,232.07
| Facility | | $1,204.98 | $1,204.98 | $1,232.07 |
- 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 |