- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $5,370.32 / $10,000.00
| Facility | | $724.44 | $5,370.32 | $10,000.00 |
- 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
- $3,311.31 / $7,762.47 / $16,595.87
| Facility | | $3,311.31 | $7,762.47 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $5,011.87 / $9,120.11
| Facility | | $758.58 | $5,011.87 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $346.74 / $416.87
| Facility | | $346.74 | $346.74 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $257.04 / $467.74
| Facility | | $204.17 | $257.04 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,548.13 / $11,481.54
| Facility | | $1,348.96 | $3,548.13 | $11,481.54 |