- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $4,073.80 / $8,317.64
| Facility | | $776.25 | $4,073.80 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $6,165.95 / $57,543.99
| Facility | | $5,011.87 | $6,165.95 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $912.01 / $912.01
| Facility | | $912.01 | $912.01 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,128.61 / $8,128.31
| Facility | | $1,698.24 | $5,128.61 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $3,801.89 / $8,317.64
| Facility | | $831.76 | $3,801.89 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $758.58 / $1,096.48
| Facility | | $758.58 | $758.58 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $478.63 / $794.33
| Facility | | $478.63 | $478.63 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,548.13 / $10,000.00
| Facility | | $1,348.96 | $3,548.13 | $10,000.00 |