- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $7,762.47 / $20,892.96
| Facility | | $1,202.26 | $7,762.47 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $870.96 / $10,000.00
| Facility | | $707.95 | $870.96 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,318.26 / $8,128.31
| Facility | | $691.83 | $1,318.26 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,230.27 / $1,288.25
| Facility | | $1,047.13 | $1,230.27 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $870.96 / $2,187.76
| Facility | | $851.14 | $870.96 | $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 |