- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,060.00 / $5,173.00 / $12,139.00
| Facility | | $2,060.00 | $5,173.00 | $12,139.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,438.00 / $10,085.44 / $14,151.33
| Facility | | $4,438.00 | $10,085.44 | $14,151.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.00 / $2,473.19 / $9,566.00
| Facility | | $687.00 | $2,473.19 | $9,566.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,472.00 / $8,801.68 / $17,424.02
| Facility | | $4,472.00 | $8,801.68 | $17,424.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,630.73 / $19,820.03 / $19,820.03
| Facility | | $11,630.73 | $19,820.03 | $19,820.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,755.13 / $9,445.20 / $16,654.32
| Facility | | $2,755.13 | $9,445.20 | $16,654.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,226.00 / $8,090.40 / $19,437.86
| Facility | | $5,226.00 | $8,090.40 | $19,437.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,100.00 / $6,067.80 / $9,650.00
| Facility | | $2,100.00 | $6,067.80 | $9,650.00 |