- 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
- $2,828.92 / $4,972.03 / $10,256.00
| Facility | | $2,828.92 | $4,972.03 | $10,256.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,280.76 / $1,280.76 / $1,339.00
| Facility | | $1,280.76 | $1,280.76 | $1,339.00 |
- 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
- $10,305.29 / $26,542.00 / $26,542.00
| Facility | | $10,305.29 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,315.16 / $1,680.56 / $2,627.66
| Facility | | $1,315.16 | $1,680.56 | $2,627.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,315.16 / $1,704.86 / $2,717.63
| Facility | | $1,315.16 | $1,704.86 | $2,717.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,200.00 / $10,600.00
| Facility | | $1,634.00 | $4,200.00 | $10,600.00 |