- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $4,073.80 / $14,454.40
| Facility | | $1,122.02 | $4,073.80 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $7,413.10 / $14,454.40
| Facility | | $4,073.80 | $7,413.10 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $562.34 / $562.34
| Facility | | $562.34 | $562.34 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $13,803.84
| Facility | | $54.95 | $56.23 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,862.09 / $7,413.10
| Facility | | $1,000.00 | $1,862.09 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,348.96 / $2,398.83
| Facility | | $1,023.29 | $1,348.96 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $8,317.64 / $17,378.01
| Facility | | $2,630.27 | $8,317.64 | $17,378.01 |