- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,258.13 / $5,128.00 / $24,827.00
| Facility | | $2,258.13 | $5,128.00 | $24,827.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,866.94 / $16,595.73 / $31,745.76
| Facility | | $9,866.94 | $16,595.73 | $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
- $2,130.66 / $3,636.07 / $11,234.92
| Facility | | $2,130.66 | $3,636.07 | $11,234.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,314.46 / $3,150.34 / $3,390.48
| Facility | | $2,314.46 | $3,150.34 | $3,390.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,279.94 / $2,301.91 / $2,513.62
| Facility | | $2,279.94 | $2,301.91 | $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
- $2,912.00 / $3,509.00 / $17,644.00
| Facility | | $2,912.00 | $3,509.00 | $17,644.00 |