- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,038.31 / $4,500.00 / $20,680.40
| Facility | | $2,038.31 | $4,500.00 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,090.00 / $2,800.00 / $12,240.97
| Facility | | $1,090.00 | $2,800.00 | $12,240.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $870.49 / $947.00
| Facility | | $500.00 | $870.49 | $947.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,435.30 / $2,997.32 / $3,801.29
| Facility | | $1,435.30 | $2,997.32 | $3,801.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,175.60 / $2,906.51 / $3,025.05
| Facility | | $2,175.60 | $2,906.51 | $3,025.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,024.00 / $2,024.00 / $2,063.36
| Facility | | $2,024.00 | $2,024.00 | $2,063.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650.00 / $1,120.00 / $5,793.00
| Facility | | $650.00 | $1,120.00 | $5,793.00 |