- 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
- $1,445.44 / $2,511.89 / $8,317.64
| Facility | | $1,445.44 | $2,511.89 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,258.93 / $1,348.96
| Facility | | $1,258.93 | $1,258.93 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $2,398.83 / $2,511.89
| Facility | | $891.25 | $2,398.83 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,818.38 / $2,818.38 / $2,818.38
| Facility | 22 | $2,818.38 | $2,818.38 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $12,589.25
| Facility | | $54.95 | $56.23 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,698.24 / $3,311.31
| Facility | | $1,258.93 | $1,698.24 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,698.24 / $2,951.21
| Facility | | $1,258.93 | $1,698.24 | $2,951.21 |
- 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 |