- 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
- $4,180.02 / $5,453.87 / $10,634.64
| Facility | | $4,180.02 | $5,453.87 | $10,634.64 |
- 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
- $443.46 / $933.12 / $6,887.55
| Facility | | $443.46 | $933.12 | $6,887.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $765.90 / $1,285.00 / $2,308.21
| Facility | | $765.90 | $1,285.00 | $2,308.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,839.11 / $3,875.52 / $7,772.00
| Facility | | $2,839.11 | $3,875.52 | $7,772.00 |