- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $7,762.47 / $20,892.96
| Facility | | $2,238.72 | $7,762.47 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $1,122.02 / $2,344.23
| Facility | | $645.65 | $1,122.02 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $2,398.83 / $5,370.32
| Facility | | $1,479.11 | $2,398.83 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $2,238.72 / $2,398.83
| Facility | | $1,659.59 | $2,238.72 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,584.89 / $1,621.81
| Facility | | $1,071.52 | $1,584.89 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $5,128.61 / $10,000.00
| Facility | | $3,548.13 | $5,128.61 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $6,918.31 / $11,748.98
| Facility | | $1,047.13 | $6,918.31 | $11,748.98 |