- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,680.99 / $5,135.00 / $10,817.74
| Facility | | $1,680.99 | $5,135.00 | $10,817.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,644.00 / $6,459.78 / $12,695.35
| Facility | | $2,644.00 | $6,459.78 | $12,695.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,429.85 / $1,715.82 / $2,123.69
| Facility | | $1,429.85 | $1,715.82 | $2,123.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.00 / $1,200.00 / $21,571.00
| Facility | | $425.00 | $1,200.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.00 / $600.00 / $1,719.01
| Facility | | $425.00 | $600.00 | $1,719.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650.00 / $2,883.00 / $6,111.00
| Facility | | $650.00 | $2,883.00 | $6,111.00 |