- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $7,762.47 / $20,892.96
| Facility | | $1,479.11 | $7,762.47 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $2,290.87 / $10,000.00
| Facility | | $707.95 | $2,290.87 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $1,584.89 / $9,549.93
| Facility | | $851.14 | $1,584.89 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,479.11 / $1,584.89
| Facility | | $1,174.90 | $1,479.11 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,071.52 / $2,187.76
| Facility | | $1,047.13 | $1,071.52 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $20,417.38 / $38,904.51
| Facility | | $13,803.84 | $20,417.38 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $21,379.62 / $41,686.94
| Facility | | $4,265.80 | $21,379.62 | $41,686.94 |