- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $7,762.47 / $20,892.96
| Facility | | $2,818.38 | $7,762.47 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,995.26 / $3,388.44
| Facility | | $707.95 | $1,995.26 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $2,511.89 / $5,011.87
| Facility | | $1,698.24 | $2,511.89 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $3,467.37 / $3,630.78
| Facility | | $2,691.53 | $3,467.37 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $2,454.71 / $2,511.89
| Facility | | $2,238.72 | $2,454.71 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $8,128.31 / $15,488.17
| Facility | | $5,370.32 | $8,128.31 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $10,000.00 / $16,595.87
| Facility | | $1,995.26 | $10,000.00 | $16,595.87 |