- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $3,890.45 / $8,317.64
| Facility | | $912.01 | $3,890.45 | $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
- $467.74 / $467.74 / $467.74
| Facility | | $467.74 | $467.74 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $2,089.30 / $7,943.28
| Facility | | $1,047.13 | $2,089.30 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $3,090.30 / $8,317.64
| Facility | | $870.96 | $3,090.30 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $354.81 / $954.99
| Facility | | $354.81 | $354.81 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $416.87 / $478.63
| Facility | | $239.88 | $416.87 | $478.63 |
- 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 |