- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $10,471.29 / $18,197.01
| Facility | | $1,698.24 | $10,471.29 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $5,623.41 / $10,000.00
| Facility | | $2,511.89 | $5,623.41 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $707.95 / $707.95
| Facility | | $707.95 | $707.95 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $758.58 / $1,513.56
| Facility | | $602.56 | $758.58 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $10,964.78 / $16,982.44
| Facility | | $1,995.26 | $10,964.78 | $16,982.44 |