- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $4,570.88 / $8,511.38
| Facility | | $2,691.53 | $4,570.88 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $6,025.60 / $22,387.21
| Facility | | $2,951.21 | $6,025.60 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $17,378.01 / $23,442.29
| Facility | | $15,135.61 | $17,378.01 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $9,549.93 / $21,877.62
| Facility | | $1,995.26 | $9,549.93 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,995.26 / $8,511.38
| Facility | | $1,202.26 | $1,995.26 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $6,918.31 / $15,488.17
| Facility | | $2,570.40 | $6,918.31 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $3,630.78 / $33,884.42
| Facility | | $3,630.78 | $3,630.78 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $6,025.60 / $22,387.21
| Facility | | $3,019.95 | $6,025.60 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $7,244.36 / $20,892.96
| Facility | | $2,570.40 | $7,244.36 | $20,892.96 |