- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $416.87 / $7,079.46
| Facility | | $416.87 | $416.87 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $6,456.54 / $12,589.25
| Facility | | $2,691.53 | $6,456.54 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,621.81 / $3,801.89
| Facility | | $1,000.00 | $1,621.81 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,548.82 / $3,019.95
| Facility | | $1,230.27 | $1,548.82 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $724.44 / $3,311.31
| Facility | | $416.87 | $724.44 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $5,248.07 / $8,912.51
| Facility | | $1,445.44 | $5,248.07 | $8,912.51 |