- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $5,754.40 / $10,964.78
| Facility | | $1,000.00 | $5,754.40 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $4,073.80 / $21,877.62
| Facility | | $954.99 | $4,073.80 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $467.74 / $6,165.95
| Facility | | $416.87 | $467.74 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $758.58 / $10,000.00
| Facility | | $575.44 | $758.58 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $758.58 / $10,000.00
| Facility | | $575.44 | $758.58 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $13,182.57
| Facility | | $100.00 | $100.00 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $8,128.31 / $14,125.38
| Facility | | $1,288.25 | $8,128.31 | $14,125.38 |