- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $8,912.51 / $20,892.96
| Facility | | $1,737.80 | $8,912.51 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,230.27 / $4,466.84
| Facility | | $1,000.00 | $1,230.27 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $1,778.28 / $4,265.80
| Facility | | $912.01 | $1,778.28 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,659.59 / $1,819.70
| Facility | | $1,258.93 | $1,659.59 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,230.27 / $1,258.93
| Facility | | $1,230.27 | $1,230.27 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $9,120.11 / $17,378.01
| Facility | | $6,760.83 | $9,120.11 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $11,220.18 / $18,620.87
| Facility | | $2,454.71 | $11,220.18 | $18,620.87 |