- 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
- $3,102.00 / $4,047.33 / $7,892.00
| Facility | | $3,102.00 | $4,047.33 | $7,892.00 |
- 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
- $555.19 / $1,198.61 / $6,887.55
| Facility | | $555.19 | $1,198.61 | $6,887.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $972.04 / $1,553.00 / $2,308.21
| Facility | | $972.04 | $1,553.00 | $2,308.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |