- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,202.26 / $8,128.31
| Facility | | $1,202.26 | $1,202.26 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $20,892.96 / $47,863.01
| Facility | | $7,585.78 | $20,892.96 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $4,570.88 / $10,715.19
| Facility | | $3,235.94 | $4,570.88 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $4,365.16 / $8,511.38
| Facility | | $3,467.37 | $4,365.16 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $2,570.40 / $12,302.69
| Facility | | $1,698.24 | $2,570.40 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $10,000.00 / $26,915.35
| Facility | | $5,888.44 | $10,000.00 | $26,915.35 |