- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $6,165.95 / $10,232.93
| Facility | | $1,412.54 | $6,165.95 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $10,000.00 / $57,543.99
| Facility | | $9,549.93 | $10,000.00 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $16,218.10 / $16,218.10
| Facility | | $16,218.10 | $16,218.10 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $5,370.32 / $9,772.37
| Facility | | $1,148.15 | $5,370.32 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,148.15 / $2,238.72
| Facility | | $1,148.15 | $1,148.15 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $691.83 / $1,071.52
| Facility | | $691.83 | $691.83 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $4,466.84 / $18,197.01
| Facility | | $2,344.23 | $4,466.84 | $18,197.01 |