- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,715.35 / $12,882.50
| Facility | | $1,000.00 | $3,715.35 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $7,585.78 / $15,135.61
| Facility | | $4,168.69 | $7,585.78 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $741.31 / $758.58
| Facility | | $79.43 | $741.31 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $28,840.32 / $28,840.32
| Facility | | $16,595.87 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,174.90 / $4,265.80
| Facility | | $794.33 | $1,174.90 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,096.48 / $1,905.46
| Facility | | $794.33 | $1,096.48 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $6,918.31 / $13,803.84
| Facility | | $2,187.76 | $6,918.31 | $13,803.84 |