- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,670.25 / $3,810.00 / $18,711.00
| Facility | | $1,670.25 | $3,810.00 | $18,711.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,866.94 / $16,394.00 / $31,745.76
| Facility | | $9,866.94 | $16,394.00 | $31,745.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,147.74 / $4,147.74 / $6,910.09
| Facility | | $4,147.74 | $4,147.74 | $6,910.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,157.09 / $1,915.78 / $6,447.65
| Facility | | $1,157.09 | $1,915.78 | $6,447.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,210.77 / $1,666.29 / $1,825.12
| Facility | | $1,210.77 | $1,666.29 | $1,825.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,234.88 / $1,243.50 / $2,513.62
| Facility | | $1,234.88 | $1,243.50 | $2,513.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,761.59 / $16,586.25 / $31,745.76
| Facility | | $10,761.59 | $16,586.25 | $31,745.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $2,431.00 / $11,261.00
| Facility | | $1,550.00 | $2,431.00 | $11,261.00 |