- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $9,120.11 / $16,595.87
| Facility | | $1,548.82 | $9,120.11 | $16,595.87 |
- 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
- $575.44 / $575.44 / $1,995.26
| Facility | | $575.44 | $575.44 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $691.83 / $1,122.02
| Facility | | $549.54 | $691.83 | $1,122.02 |
- 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 |