- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $6,309.57 / $15,488.17
| Facility | | $1,412.54 | $6,309.57 | $15,488.17 |
- 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
- $6,309.57 / $15,488.17 / $27,542.29
| Facility | | $6,309.57 | $15,488.17 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $6,025.60 / $15,488.17
| Facility | | $1,230.27 | $6,025.60 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $758.58 / $1,548.82
| Facility | | $758.58 | $758.58 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $758.58 / $933.25
| Facility | | $758.58 | $758.58 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $5,495.41 / $18,620.87
| Facility | | $2,454.71 | $5,495.41 | $18,620.87 |