- 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
- $1,318.26 / $2,238.72 / $4,466.84
| Facility | | $1,318.26 | $2,238.72 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $380.19 / $380.19
| Facility | | $79.43 | $380.19 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $33,884.42 / $33,884.42
| Facility | | $4,786.30 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $562.34 / $4,073.80
| Facility | | $380.19 | $562.34 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $489.78 / $851.14
| Facility | | $380.19 | $489.78 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,511.89 / $4,786.30
| Facility | | $724.44 | $2,511.89 | $4,786.30 |