- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $4,786.30 / $9,549.93
| Facility | | $1,047.13 | $4,786.30 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $10,000.00 / $57,543.99
| Facility | | $9,549.93 | $10,000.00 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,047.13 / $1,047.13
| Facility | | $1,047.13 | $1,047.13 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $7,762.47 / $13,182.57
| Facility | | $7,762.47 | $7,762.47 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $3,890.45 / $8,511.38
| Facility | | $831.76 | $3,890.45 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $794.33 / $1,288.25
| Facility | | $794.33 | $794.33 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $478.63 / $630.96
| Facility | | $478.63 | $478.63 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $4,466.84 / $22,387.21
| Facility | | $2,344.23 | $4,466.84 | $22,387.21 |