- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,005.00 / $10,563.53 / $20,928.72
| Facility | | $5,005.00 | $10,563.53 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,180.02 / $5,453.87 / $10,634.64
| Facility | | $4,180.02 | $5,453.87 | $10,634.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,821.47 / $1,821.47 / $1,821.47
| Facility | | $1,821.47 | $1,821.47 | $1,821.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,032.63 / $2,291.14 / $7,741.80
| Facility | | $1,032.63 | $2,291.14 | $7,741.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,285.00 / $2,185.76 / $2,925.61
| Facility | | $1,285.00 | $2,185.76 | $2,925.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,711.00 / $5,356.00 / $7,772.00
| Facility | | $3,711.00 | $5,356.00 | $7,772.00 |