- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.54 / $1,182.80 / $13,750.00
| Facility | | $641.54 | $1,182.80 | $13,750.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,140.42 / $8,552.21 / $12,000.00
| Facility | | $1,140.42 | $8,552.21 | $12,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.83 / $568.48 / $3,302.92
| Facility | | $466.83 | $568.48 | $3,302.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $432.37 / $787.49 / $2,494.19
| Facility | | $432.37 | $787.49 | $2,494.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $619.19 / $858.94 / $935.99
| Facility | | $619.19 | $858.94 | $935.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $629.66 / $904.15 / $1,781.59
| Facility | | $629.66 | $904.15 | $1,781.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,916.52 / $9,118.81 / $17,453.22
| Facility | | $5,916.52 | $9,118.81 | $17,453.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650.00 / $1,120.00 / $6,857.00
| Facility | | $650.00 | $1,120.00 | $6,857.00 |