- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.39 / $5,977.00 / $14,616.34
| Facility | | $1,200.39 | $5,977.00 | $14,616.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $28,970.26
| Facility | | $8,639.91 | $11,851.00 | $28,970.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $771.00 / $771.00 / $771.00
| Facility | | $771.00 | $771.00 | $771.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,545.30 / $9,657.37 / $39,214.85
| Facility | | $5,545.30 | $9,657.37 | $39,214.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.39 / $5,958.00 / $12,400.37
| Facility | | $1,200.39 | $5,958.00 | $12,400.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $771.00 / $771.00 / $771.00
| Facility | | $771.00 | $771.00 | $771.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,076.68 / $1,076.68 / $1,327.53
| Facility | | $1,076.68 | $1,076.68 | $1,327.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,843.00 / $3,914.00 / $7,508.00
| Facility | | $1,843.00 | $3,914.00 | $7,508.00 |