- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $7,943.28 / $20,892.96
| Facility | | $1,479.11 | $7,943.28 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,023.29 / $10,000.00
| Facility | | $1,023.29 | $1,023.29 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $2,511.89 / $10,964.78
| Facility | | $1,348.96 | $2,511.89 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,445.44 / $1,905.46
| Facility | | $1,174.90 | $1,445.44 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,047.13 / $1,862.09
| Facility | | $977.24 | $1,047.13 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $14,791.08 / $28,183.83
| Facility | | $9,549.93 | $14,791.08 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $16,218.10 / $30,199.52
| Facility | | $2,398.83 | $16,218.10 | $30,199.52 |