- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $4,786.30 / $10,964.78
| Facility | | $2,570.40 | $4,786.30 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $11,481.54 / $19,054.61
| Facility | | $4,786.30 | $11,481.54 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $3,548.13 / $37,153.52
| Facility | | $3,548.13 | $3,548.13 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $4,466.84 / $50,118.72
| Facility | | $34.67 | $4,466.84 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $5,370.32 / $10,000.00
| Facility | | $2,754.23 | $5,370.32 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $2,398.83 / $2,398.83
| Facility | | $2,398.83 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $50,118.72 / $75,857.76
| Facility | | $2,630.27 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $4,168.69 / $9,120.11
| Facility | | $1,479.11 | $4,168.69 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $2,951.21 / $11,220.18
| Facility | | $2,041.74 | $2,951.21 | $11,220.18 |