- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $5,888.44 / $10,964.78
| Facility | | $954.99 | $5,888.44 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,884.03 / $7,943.28
| Facility | | $1,000.00 | $2,884.03 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $588.84
| Facility | | $501.19 | $501.19 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $794.33 / $21,379.62
| Facility | | $512.86 | $794.33 | $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 / $1,949.84
| Facility | | $100.00 | $100.00 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $1,023.29 / $3,235.94
| Facility | | $478.63 | $1,023.29 | $3,235.94 |