- 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
- $2,187.76 / $3,548.13 / $8,511.38
| Facility | | $2,187.76 | $3,548.13 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $1,862.09 / $2,041.74
| Facility | | $1,862.09 | $1,862.09 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $2,511.89 / $3,467.37
| Facility | | $891.25 | $2,511.89 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $18,620.87
| Facility | | $54.95 | $56.23 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $2,511.89 / $4,570.88
| Facility | | $1,905.46 | $2,511.89 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $2,511.89 / $4,365.16
| Facility | | $1,905.46 | $2,511.89 | $4,365.16 |
- 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 |