- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $3,715.35 / $8,317.64
| Facility | | $588.84 | $3,715.35 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $6,165.95 / $57,543.99
| Facility | | $5,011.87 | $6,165.95 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $588.84 / $588.84
| Facility | | $588.84 | $588.84 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $10,964.78 / $11,220.18
| Facility | | $10,964.78 | $10,964.78 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,691.53 / $8,317.64
| Facility | | $724.44 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $1,071.52
| Facility | | $501.19 | $501.19 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $446.68 / $501.19
| Facility | | $338.84 | $446.68 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,548.13 / $10,000.00
| Facility | | $1,348.96 | $3,548.13 | $10,000.00 |