- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $5,888.44 / $10,964.78
| Facility | | $831.76 | $5,888.44 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $7,079.46 / $30,199.52
| Facility | | $1,000.00 | $7,079.46 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $446.68 / $8,912.51
| Facility | | $407.38 | $446.68 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $724.44 / $14,454.40
| Facility | | $34.67 | $724.44 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $724.44 / $14,454.40
| Facility | | $562.34 | $724.44 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $13,182.57
| Facility | | $100.00 | $100.00 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $5,495.41 / $9,120.11
| Facility | | $933.25 | $5,495.41 | $9,120.11 |