- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $10,000.00 / $22,387.21
| Facility | | $2,884.03 | $10,000.00 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $9,120.11 / $18,620.87
| Facility | | $4,168.69 | $9,120.11 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $5,495.41 / $5,495.41
| Facility | | $5,495.41 | $5,495.41 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,445.44 / $15,848.93
| Facility | | $707.95 | $1,445.44 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $16,218.10 / $22,908.68
| Facility | | $12,882.50 | $16,218.10 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $11,748.98 / $29,512.09
| Facility | | $2,570.40 | $11,748.98 | $29,512.09 |