- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,361.81 / $5,135.00 / $10,817.74
| Facility | | $1,361.81 | $5,135.00 | $10,817.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,712.00 / $3,405.00 / $14,996.00
| Facility | | $1,712.00 | $3,405.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,102.47 / $1,351.58 / $1,994.14
| Facility | | $1,102.47 | $1,351.58 | $1,994.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.66 / $1,469.12 / $21,571.00
| Facility | | $1,023.66 | $1,469.12 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,469.12 / $1,469.12 / $1,638.24
| Facility | | $1,469.12 | $1,469.12 | $1,638.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $5,460.00 / $7,847.00
| Facility | | $2,155.00 | $5,460.00 | $7,847.00 |