- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $3,388.44 / $7,762.47
| Facility | | $1,096.48 | $3,388.44 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $10,000.00 / $15,488.17
| Facility | | $4,897.79 | $10,000.00 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $39.81 / $39.81
| Facility | | $39.81 | $39.81 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $8,912.51 / $20,892.96
| Facility | | $5,623.41 | $8,912.51 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $6,456.54 / $12,882.50
| Facility | | $1,202.26 | $6,456.54 | $12,882.50 |