- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $8,511.38 / $21,877.62
| Facility | | $3,311.31 | $8,511.38 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $10,000.00 / $19,054.61
| Facility | | $4,365.16 | $10,000.00 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $3,630.78 / $4,677.35
| Facility | | $501.19 | $3,630.78 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,000.00 / $1,621.81
| Facility | | $691.83 | $1,000.00 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $20,417.38 / $25,703.96
| Facility | | $8,709.64 | $20,417.38 | $25,703.96 |