- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $10,000.00 / $18,197.01
| Facility | | $1,348.96 | $10,000.00 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $7,585.78 / $14,125.38
| Facility | | $3,235.94 | $7,585.78 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $2,818.38 / $2,818.38
| Facility | | $2,818.38 | $2,818.38 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $707.95 / $1,174.90
| Facility | | $478.63 | $707.95 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $13,182.57 / $23,988.33
| Facility | | $5,128.61 | $13,182.57 | $23,988.33 |