- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $4,073.80 / $8,511.38
| Facility | | $1,047.13 | $4,073.80 | $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
- $676.08 / $676.08 / $676.08
| Facility | | $676.08 | $676.08 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $3,235.94 / $8,317.64
| Facility | | $954.99 | $3,235.94 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $707.95 / $776.25
| Facility | | $707.95 | $707.95 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $416.87 / $758.58
| Facility | | $380.19 | $416.87 | $758.58 |
- 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 |