- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,715.35 / $12,882.50
| Facility | | $1,000.00 | $3,715.35 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $5,754.40 / $18,620.87
| Facility | | $3,388.44 | $5,754.40 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $2,951.21 / $3,235.94
| Facility | | $2,951.21 | $2,951.21 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $2,511.89 / $5,623.41
| Facility | | $891.25 | $2,511.89 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $51,286.14
| Facility | | $54.95 | $56.23 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $3,981.07 / $7,244.36
| Facility | | $2,951.21 | $3,981.07 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $4,073.80 / $6,918.31
| Facility | | $3,019.95 | $4,073.80 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $2,290.87 / $10,000.00
| Facility | | $407.38 | $2,290.87 | $10,000.00 |