- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,174.90 / $6,760.83
| Facility | | $1,174.90 | $1,174.90 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $10,000.00 / $23,442.29
| Facility | | $3,090.30 | $10,000.00 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $4,073.80 / $9,772.37
| Facility | | $2,884.03 | $4,073.80 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $3,890.45 / $7,585.78
| Facility | | $3,162.28 | $3,890.45 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,995.26 / $6,760.83
| Facility | | $1,202.26 | $1,995.26 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $7,079.46 / $13,489.63
| Facility | | $3,548.13 | $7,079.46 | $13,489.63 |