- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,084.00 / $4,410.00 / $10,584.71
| Facility | | $1,084.00 | $4,410.00 | $10,584.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,150.00 / $7,463.00 / $11,091.00
| Facility | | $4,150.00 | $7,463.00 | $11,091.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.38 / $616.38 / $616.38
| Facility | | $616.38 | $616.38 | $616.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,881.25 / $5,031.35 / $8,524.98
| Facility | | $2,881.25 | $5,031.35 | $8,524.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $4,606.00 / $10,527.00
| Facility | | $954.00 | $4,606.00 | $10,527.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.38 / $616.38 / $616.38
| Facility | | $616.38 | $616.38 | $616.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $525.57 / $525.57 / $864.29
| Facility | | $525.57 | $525.57 | $864.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,475.00 / $6,368.00
| Facility | | $2,155.00 | $3,475.00 | $6,368.00 |