- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,017.00 / $3,682.00 / $12,281.00
| Facility | | $1,017.00 | $3,682.00 | $12,281.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,814.35 / $4,909.47 / $9,381.18
| Facility | | $2,814.35 | $4,909.47 | $9,381.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,468.11 / $1,468.11 / $1,538.39
| Facility | | $1,468.11 | $1,468.11 | $1,538.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,953.70 / $1,953.70 / $2,017.56
| Facility | | $1,953.70 | $1,953.70 | $2,017.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,500.00 / $26,542.00 / $26,542.00
| Facility | | $11,500.00 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,614.69 / $2,064.11 / $3,055.50
| Facility | | $1,614.69 | $2,064.11 | $3,055.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,614.69 / $2,064.23 / $3,293.39
| Facility | | $1,614.69 | $2,064.23 | $3,293.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,405.00 / $10,600.00
| Facility | | $1,634.00 | $4,405.00 | $10,600.00 |