- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $7,943.28 / $22,908.68
| Facility | | $3,981.07 | $7,943.28 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $758.58 / $870.96
| Facility | | $758.58 | $758.58 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $4,265.80 / $36,307.81
| Facility | | $2,187.76 | $4,265.80 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $4,073.80 / $4,265.80
| Facility | | $3,235.94 | $4,073.80 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $2,818.38 / $2,951.21
| Facility | | $2,818.38 | $2,818.38 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,307.81 / $46,773.51 / $91,201.08
| Facility | | $36,307.81 | $46,773.51 | $91,201.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $51,286.14 / $100,000.00
| Facility | | $6,309.57 | $51,286.14 | $100,000.00 |