- 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
- $891.25 / $1,513.56 / $8,912.51
| Facility | | $891.25 | $1,513.56 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $812.83 / $812.83
| Facility | | $79.43 | $812.83 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $7,079.46
| Facility | | $54.95 | $56.23 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $1,148.15 / $4,265.80
| Facility | | $831.76 | $1,148.15 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $1,096.48 / $1,862.09
| Facility | | $812.83 | $1,096.48 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $8,128.31 / $17,378.01
| Facility | | $2,630.27 | $8,128.31 | $17,378.01 |