- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $8,912.51 / $12,302.69
| Facility | | $1,230.27 | $8,912.51 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,365.16 / $16,982.44
| Facility | | $2,238.72 | $4,365.16 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $707.95 / $794.33
| Facility | | $660.69 | $707.95 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $831.76 / $21,379.62
| Facility | | $602.56 | $831.76 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $21,379.62 / $21,379.62
| Facility | | $21,379.62 | $21,379.62 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $7,244.36
| Facility | | $100.00 | $100.00 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $6,606.93 / $10,964.78
| Facility | | $3,890.45 | $6,606.93 | $10,964.78 |