- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $13,803.84 / $29,512.09
| Facility | | $2,630.27 | $13,803.84 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $10,000.00 / $19,054.61
| Facility | | $4,265.80 | $10,000.00 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $3,630.78 / $4,677.35
| Facility | | $3,630.78 | $3,630.78 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $741.31 / $1,174.90
| Facility | | $501.19 | $741.31 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $20,417.38 / $25,703.96
| Facility | | $8,709.64 | $20,417.38 | $25,703.96 |