- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $7,943.28 / $20,892.96
| Facility | | $1,122.02 | $7,943.28 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $912.01 / $2,884.03
| Facility | | $912.01 | $912.01 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,412.54 / $5,888.44
| Facility | | $724.44 | $1,412.54 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $1,122.02 / $1,174.90
| Facility | | $831.76 | $1,122.02 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $812.83 / $1,000.00
| Facility | | $776.25 | $812.83 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $6,606.93 / $12,589.25
| Facility | | $4,786.30 | $6,606.93 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $7,244.36 / $13,182.57
| Facility | | $1,380.38 | $7,244.36 | $13,182.57 |