- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.14 / $1,166.25 / $14,464.32
| Facility | | $606.14 | $1,166.25 | $14,464.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,304.78 / $4,554.63 / $11,500.00
| Facility | | $1,304.78 | $4,554.63 | $11,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.83 / $568.48 / $1,985.59
| Facility | | $466.83 | $568.48 | $1,985.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $429.97 / $861.06 / $1,472.45
| Facility | | $429.97 | $861.06 | $1,472.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $623.07 / $861.62 / $960.11
| Facility | | $623.07 | $861.62 | $960.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.44 / $632.84 / $1,613.81
| Facility | | $537.44 | $632.84 | $1,613.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,953.48 / $4,552.03 / $8,712.50
| Facility | | $2,953.48 | $4,552.03 | $8,712.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.00 / $546.00 / $5,793.00
| Facility | | $157.00 | $546.00 | $5,793.00 |