- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $8,128.31 / $20,892.96
| Facility | | $1,513.56 | $8,128.31 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,071.52 / $10,000.00
| Facility | | $891.25 | $1,071.52 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,513.56 / $8,128.31
| Facility | | $794.33 | $1,513.56 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,412.54 / $1,584.89
| Facility | | $1,047.13 | $1,412.54 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,071.52 / $2,187.76
| Facility | | $1,071.52 | $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
- $2,454.71 / $21,379.62 / $41,686.94
| Facility | | $2,454.71 | $21,379.62 | $41,686.94 |