- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $4,677.35 / $10,471.29
| Facility | | $2,290.87 | $4,677.35 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $12,302.69 / $25,703.96
| Facility | | $8,317.64 | $12,302.69 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $2,187.76 / $2,187.76
| Facility | | $2,187.76 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $9,549.93 / $10,000.00
| Facility | | $9,332.54 | $9,549.93 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $3,467.37 / $6,760.83
| Facility | | $1,288.25 | $3,467.37 | $6,760.83 |