- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,715.35 / $12,882.50
| Facility | | $1,000.00 | $3,715.35 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $2,570.40 / $2,691.53
| Facility | | $2,570.40 | $2,570.40 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $2,511.89 / $5,011.87
| Facility | | $891.25 | $2,511.89 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $37,153.52
| Facility | | $54.95 | $56.23 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $3,548.13 / $6,606.93
| Facility | | $2,511.89 | $3,548.13 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $3,548.13 / $6,309.57
| Facility | | $2,570.40 | $3,548.13 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $2,290.87 / $10,000.00
| Facility | | $407.38 | $2,290.87 | $10,000.00 |