- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $12,589.25 / $28,840.32
| Facility | | $1,445.44 | $12,589.25 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $4,073.80 / $6,760.83
| Facility | | $4,073.80 | $4,073.80 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,819.70 / $15,488.17
| Facility | | $1,000.00 | $1,819.70 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,479.11 / $1,584.89
| Facility | | $1,096.48 | $1,479.11 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,071.52 / $1,071.52
| Facility | | $1,047.13 | $1,071.52 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $16,218.10 / $31,622.78
| Facility | | $10,715.19 | $16,218.10 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $20,892.96 / $36,307.81
| Facility | | $4,265.80 | $20,892.96 | $36,307.81 |