- 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
- $4,265.80 / $9,549.93 / $17,782.79
| Facility | | $4,265.80 | $9,549.93 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $602.56 / $616.60
| Facility | | $79.43 | $602.56 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $33,884.42 / $33,884.42
| Facility | | $19,952.62 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $954.99 / $4,073.80
| Facility | | $645.65 | $954.99 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $851.14 / $1,412.54
| Facility | | $645.65 | $851.14 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,248.07 / $11,220.18
| Facility | | $1,698.24 | $5,248.07 | $11,220.18 |