- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,290.87 / $3,801.89
| Facility | | $1,000.00 | $2,290.87 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $2,344.23 / $19,498.45
| Facility | | $616.60 | $2,344.23 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $478.63 / $1,412.54
| Facility | | $446.68 | $478.63 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $891.25 / $7,079.46
| Facility | | $380.19 | $891.25 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $3,162.28 / $8,511.38
| Facility | | $616.60 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $3,890.45 / $3,890.45
| Facility | | $3,890.45 | $3,890.45 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $2,344.23 / $19,498.45
| Facility | | $616.60 | $2,344.23 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $3,019.95 / $8,511.38
| Facility | | $676.08 | $3,019.95 | $8,511.38 |