- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $9,332.54 / $10,000.00
| Facility | | $2,238.72 | $9,332.54 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $8,128.31 / $18,620.87
| Facility | | $3,090.30 | $8,128.31 | $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
- $891.25 / $1,584.89 / $7,762.47
| Facility | | $891.25 | $1,584.89 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $16,218.10 / $22,908.68
| Facility | | $12,022.64 | $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 |