- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $7,943.28 / $20,892.96
| Facility | | $2,818.38 | $7,943.28 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,288.25 / $2,344.23
| Facility | | $794.33 | $1,288.25 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $3,235.94 / $7,762.47
| Facility | | $1,819.70 | $3,235.94 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $3,090.30 / $3,235.94
| Facility | | $2,290.87 | $3,090.30 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $2,187.76 / $2,187.76
| Facility | | $1,071.52 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $5,128.61 / $10,000.00
| Facility | | $3,801.89 | $5,128.61 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $7,244.36 / $11,748.98
| Facility | | $1,862.09 | $7,244.36 | $11,748.98 |