- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $6,165.95 / $9,772.37
| Facility | | $1,479.11 | $6,165.95 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $10,000.00 / $57,543.99
| Facility | | $9,549.93 | $10,000.00 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $25,118.86 / $33,113.11
| Facility | | $16,218.10 | $25,118.86 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $5,128.61 / $9,772.37
| Facility | | $1,288.25 | $5,128.61 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $1,737.80 / $2,754.23
| Facility | | $1,737.80 | $1,737.80 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $1,412.54 / $1,412.54
| Facility | | $1,348.96 | $1,412.54 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $5,495.41 / $33,113.11
| Facility | | $2,454.71 | $5,495.41 | $33,113.11 |