- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,722.49 / $5,116.62 / $20,680.40
| Facility | | $1,722.49 | $5,116.62 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,132.17 / $12,529.85 / $20,760.75
| Facility | | $2,132.17 | $12,529.85 | $20,760.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $714.97 / $947.00
| Facility | | $500.00 | $714.97 | $947.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.75 / $1,982.15 / $3,229.57
| Facility | | $1,041.75 | $1,982.15 | $3,229.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,365.29 / $1,824.81 / $1,914.19
| Facility | | $1,365.29 | $1,824.81 | $1,914.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.07 / $1,439.64 / $3,045.78
| Facility | | $1,286.07 | $1,439.64 | $3,045.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,290.07 / $10,853.10 / $20,996.48
| Facility | | $8,290.07 | $10,853.10 | $20,996.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.00 / $2,759.00 / $11,941.00
| Facility | | $1,300.00 | $2,759.00 | $11,941.00 |