- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $4,073.80 / $14,454.40
| Facility | | $1,096.48 | $4,073.80 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $3,311.31 / $6,760.83
| Facility | | $1,905.46 | $3,311.31 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $1,949.84 / $1,949.84
| Facility | | $645.65 | $1,949.84 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $33,884.42 / $33,884.42
| Facility | | $6,918.31 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $4,786.30 / $4,786.30 / $4,786.30
| Facility | 54 | $4,786.30 | $4,786.30 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,148.15 / $6,309.57
| Facility | | $707.95 | $1,148.15 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $870.96 / $1,584.89
| Facility | | $691.83 | $870.96 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $3,981.07 / $8,709.64
| Facility | | $1,258.93 | $3,981.07 | $8,709.64 |