- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,918.58 / $6,470.00 / $24,827.00
| Facility | | $1,918.58 | $6,470.00 | $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
- $1,798.86 / $3,043.89 / $11,234.92
| Facility | | $1,798.86 | $3,043.89 | $11,234.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,910.38 / $2,629.75 / $2,843.08
| Facility | | $1,910.38 | $2,629.75 | $2,843.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,921.17 / $1,936.77 / $2,513.62
| Facility | | $1,921.17 | $1,936.77 | $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 |