- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,264.57 / $3,020.00 / $9,661.00
| Facility | | $1,264.57 | $3,020.00 | $9,661.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,283.00 / $4,975.00 / $11,448.00
| Facility | | $3,283.00 | $4,975.00 | $11,448.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.44 / $1,518.44 / $37,499.62
| Facility | | $1,518.44 | $1,518.44 | $37,499.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,226.75 / $1,226.75 / $7,227.90
| Facility | | $1,226.75 | $1,226.75 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.00 / $1,490.00 / $2,899.82
| Facility | | $332.00 | $1,490.00 | $2,899.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $995.43 / $995.43 / $995.43
| Facility | | $995.43 | $995.43 | $995.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.00 / $1,226.75 / $7,227.90
| Facility | | $597.00 | $1,226.75 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $996.00 / $4,194.00 / $9,020.04
| Facility | | $996.00 | $4,194.00 | $9,020.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,272.32 / $1,272.32 / $3,697.60
| Facility | | $1,272.32 | $1,272.32 | $3,697.60 |