- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,068.00 / $5,471.00 / $15,790.00
| Facility | | $2,068.00 | $5,471.00 | $15,790.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,650.00 / $12,295.35 / $22,403.84
| Facility | | $3,650.00 | $12,295.35 | $22,403.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $655.00 / $2,753.00 / $14,969.18
| Facility | | $655.00 | $2,753.00 | $14,969.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,022.00 / $13,155.48 / $27,694.43
| Facility | | $7,022.00 | $13,155.48 | $27,694.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,007.48 / $34,094.93 / $34,094.93
| Facility | | $20,007.48 | $34,094.93 | $34,094.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,157.00 / $7,390.00 / $25,765.77
| Facility | | $2,157.00 | $7,390.00 | $25,765.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,103.00 / $12,323.40 / $30,895.30
| Facility | | $8,103.00 | $12,323.40 | $30,895.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,100.00 / $6,725.00 / $13,101.38
| Facility | | $2,100.00 | $6,725.00 | $13,101.38 |