- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,953.24 / $7,920.26 / $27,982.24
| Facility | | $2,953.24 | $7,920.26 | $27,982.24 |
- 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
- $2,000.04 / $3,386.08 / $11,234.92
| Facility | | $2,000.04 | $3,386.08 | $11,234.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,218.41 / $2,937.28 / $3,168.43
| Facility | | $2,218.41 | $2,937.28 | $3,168.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.71 / $2,161.15 / $2,513.62
| Facility | | $2,137.71 | $2,161.15 | $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
- $3,478.00 / $5,267.50 / $16,315.00
| Facility | | $3,478.00 | $5,267.50 | $16,315.00 |