- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,505.00 / $26,167.20 / $44,357.70
| Facility | | $4,505.00 | $26,167.20 | $44,357.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,499.00 / $3,596.00 / $31,519.10
| Facility | | $1,499.00 | $3,596.00 | $31,519.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,812.00 / $11,225.17 / $28,046.87
| Facility | | $5,812.00 | $11,225.17 | $28,046.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,200.00 / $17,953.65 / $23,755.60
| Facility | | $2,200.00 | $17,953.65 | $23,755.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,691.00 / $18,286.09 / $29,880.42
| Facility | | $1,691.00 | $18,286.09 | $29,880.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $2,955.34 / $3,794.00
| Facility | | $1,500.00 | $2,955.34 | $3,794.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $16,615.00 / $43,282.57
| Facility | | $3,775.00 | $16,615.00 | $43,282.57 |