- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.31 / $1,847.31 / $14,464.32
| Facility | | $157.31 | $1,847.31 | $14,464.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,084.46 / $5,068.58 / $12,000.00
| Facility | | $1,084.46 | $5,068.58 | $12,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.83 / $568.48 / $2,046.84
| Facility | | $466.83 | $568.48 | $2,046.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.19 / $600.41 / $2,131.73
| Facility | | $128.19 | $600.41 | $2,131.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.86 / $1,502.74 / $1,813.56
| Facility | | $213.86 | $1,502.74 | $1,813.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $726.69 / $1,084.46 / $1,167.02
| Facility | | $726.69 | $1,084.46 | $1,167.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.71 / $5,392.38 / $10,315.01
| Facility | | $3,496.71 | $5,392.38 | $10,315.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,120.00 / $6,576.25 / $9,713.75
| Facility | | $1,120.00 | $6,576.25 | $9,713.75 |