- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $4,786.30 / $8,317.64
| Facility | | $1,096.48 | $4,786.30 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $7,585.78 / $57,543.99
| Facility | | $6,456.54 | $7,585.78 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $870.96 / $870.96
| Facility | | $870.96 | $870.96 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $5,128.61 / $11,481.54
| Facility | | $3,311.31 | $5,128.61 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $3,890.45 / $8,317.64
| Facility | | $1,023.29 | $3,890.45 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $831.76 / $1,047.13
| Facility | | $831.76 | $831.76 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $467.74 / $831.76
| Facility | | $467.74 | $467.74 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $3,981.07 / $10,000.00
| Facility | | $2,089.30 | $3,981.07 | $10,000.00 |