- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $7,838.38 / $7,838.38
| Facility | | $1,000.00 | $7,838.38 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,042.35 / $39,533.49 / $64,473.94
| Facility | | $16,042.35 | $39,533.49 | $64,473.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,429.01 / $1,429.01 / $1,429.01
| Facility | | $1,429.01 | $1,429.01 | $1,429.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,147.81 / $1,460.86 / $1,867.91
| Facility | | $1,147.81 | $1,460.86 | $1,867.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,012.00 / $21,608.00 / $23,186.00
| Facility | | $4,012.00 | $21,608.00 | $23,186.00 |