- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,560.00 / $12,274.80 / $27,076.14
| Facility | | $1,560.00 | $12,274.80 | $27,076.14 |
- 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
- $1,327.62 / $2,286.25 / $11,234.92
| Facility | | $1,327.62 | $2,286.25 | $11,234.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,516.55 / $1,979.85 / $2,127.04
| Facility | | $1,516.55 | $1,979.85 | $2,127.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,416.98 / $1,436.35 / $2,513.62
| Facility | | $1,416.98 | $1,436.35 | $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 |