- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $7,413.10 / $10,964.78
| Facility | | $3,890.45 | $7,413.10 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $4,365.16 / $12,022.64
| Facility | | $3,715.35 | $4,365.16 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,187.76 / $3,548.13
| Facility | | $1,000.00 | $2,187.76 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $3,019.95 / $3,162.28
| Facility | | $1,023.29 | $3,019.95 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $4,168.69 / $9,120.11
| Facility | | $2,290.87 | $4,168.69 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $6,760.83 / $10,000.00
| Facility | | $831.76 | $6,760.83 | $10,000.00 |