- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $2,041.74 / $14,454.40
| Facility | | $1,258.93 | $2,041.74 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $13,803.84 / $21,877.62
| Facility | | $10,000.00 | $13,803.84 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $2,951.21 / $4,786.30
| Facility | | $2,570.40 | $2,951.21 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $7,413.10 / $14,454.40
| Facility | | $1,174.90 | $7,413.10 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $3,388.44 / $9,549.93
| Facility | | $1,148.15 | $3,388.44 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,778.28 / $2,511.89 / $4,265.80
| Professional | | $1,778.28 | $2,511.89 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $2,570.40 / $10,715.19
| Facility | | $2,570.40 | $2,570.40 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $6,165.95 / $19,498.45
| Facility | | $2,290.87 | $6,165.95 | $19,498.45 |