- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,163.91 / $4,132.00 / $13,401.00
| Facility | | $1,163.91 | $4,132.00 | $13,401.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,121.85 / $7,421.31 / $14,454.58
| Facility | | $4,121.85 | $7,421.31 | $14,454.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,060.05 / $1,060.05 / $1,060.05
| Facility | | $1,060.05 | $1,060.05 | $1,060.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,187.68 / $4,187.68 / $4,187.68
| Facility | | $4,187.68 | $4,187.68 | $4,187.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,500.00 / $26,542.00 / $26,542.00
| Facility | | $11,500.00 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,172.93 / $1,584.67 / $2,887.50
| Facility | | $1,172.93 | $1,584.67 | $2,887.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,180.03 / $1,584.75 / $3,150.00
| Facility | | $1,180.03 | $1,584.75 | $3,150.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,093.00 / $6,000.00 / $13,134.00
| Facility | | $2,093.00 | $6,000.00 | $13,134.00 |