- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $1,380.38 / $7,762.47
| Facility | | $1,380.38 | $1,380.38 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $26,915.35 / $81,283.05
| Facility | | $15,135.61 | $26,915.35 | $81,283.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,677.35 / $10,964.78
| Facility | | $3,311.31 | $4,677.35 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $4,466.84 / $8,709.64
| Facility | | $3,548.13 | $4,466.84 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $3,019.95 / $12,302.69
| Facility | | $1,905.46 | $3,019.95 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $10,000.00 / $28,840.32
| Facility | | $5,888.44 | $10,000.00 | $28,840.32 |