- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $3,801.89 / $12,882.50
| Facility | | $1,096.48 | $3,801.89 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $7,762.47 / $15,135.61
| Facility | | $4,265.80 | $7,762.47 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $4,073.80 / $4,073.80
| Facility | | $933.25 | $4,073.80 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $1,995.26 / $16,595.87
| Facility | | $1,995.26 | $1,995.26 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,479.11 / $4,365.16
| Facility | | $1,000.00 | $1,479.11 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,380.38 / $2,398.83
| Facility | | $1,000.00 | $1,380.38 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $6,918.31 / $13,803.84
| Facility | | $2,187.76 | $6,918.31 | $13,803.84 |