- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,890.45 / $12,882.50
| Facility | | $1,000.00 | $3,890.45 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $4,365.16 / $8,317.64
| Facility | | $2,344.23 | $4,365.16 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $2,187.76 / $3,801.89
| Facility | | $309.03 | $2,187.76 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $676.08 / $676.08
| Facility | | $79.43 | $676.08 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $33,884.42 / $33,884.42
| Facility | | $11,748.98 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,000.00 / $4,265.80
| Facility | | $691.83 | $1,000.00 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $933.25 / $1,513.56
| Facility | | $691.83 | $933.25 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,511.89 / $4,897.79
| Facility | | $724.44 | $2,511.89 | $4,897.79 |