- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $5,370.32 / $8,511.38
| Facility | | $1,174.90 | $5,370.32 | $8,511.38 |
- 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
- $1,202.26 / $1,202.26 / $1,202.26
| Facility | | $1,202.26 | $1,202.26 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $7,585.78 / $11,481.54
| Facility | | $2,137.96 | $7,585.78 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $4,570.88 / $8,511.38
| Facility | | $1,023.29 | $4,570.88 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $831.76 / $1,548.82
| Facility | | $831.76 | $831.76 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $831.76
| Facility | | $575.44 | $575.44 | $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 |