- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $4,897.79 / $18,620.87
| Facility | | $1,000.00 | $4,897.79 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $25,703.96 / $32,359.37
| Facility | | $4,570.88 | $25,703.96 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $676.08 / $776.25
| Facility | | $660.69 | $676.08 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,096.48 / $1,659.59
| Facility | | $691.83 | $1,096.48 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $11,220.18 / $17,378.01
| Facility | | $4,897.79 | $11,220.18 | $17,378.01 |