- 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
- $1,380.38 / $2,344.23 / $8,317.64
| Facility | | $1,380.38 | $2,344.23 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,148.15 / $1,230.27
| Facility | | $1,148.15 | $1,148.15 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $2,290.87 / $2,511.89
| Facility | | $891.25 | $2,290.87 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $16,982.44
| Facility | | $54.95 | $56.23 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,778.28 / $3,311.31
| Facility | | $1,230.27 | $1,778.28 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,778.28 / $3,090.30
| Facility | | $1,258.93 | $1,778.28 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $3,890.45 / $8,511.38
| Facility | | $1,380.38 | $3,890.45 | $8,511.38 |