- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $4,265.80 / $10,964.78
| Facility | | $1,230.27 | $4,265.80 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $7,762.47 / $13,803.84
| Facility | | $3,981.07 | $7,762.47 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,995.26 / $8,912.51
| Facility | | $1,202.26 | $1,995.26 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,445.44 / $50,118.72
| Facility | | $1,445.44 | $1,445.44 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $1,023.29 / $2,951.21
| Facility | | $812.83 | $1,023.29 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $812.83 / $812.83
| Facility | | $812.83 | $812.83 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $50,118.72 / $75,857.76
| Facility | | $912.01 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $5,888.44 / $16,982.44
| Facility | | $2,398.83 | $5,888.44 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,000.00 / $3,981.07
| Facility | | $691.83 | $1,000.00 | $3,981.07 |