- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,109.32 / $3,984.59 / $20,680.40
| Facility | | $2,109.32 | $3,984.59 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,135.56 / $14,371.76
| Facility | | $55.00 | $2,135.56 | $14,371.76 |
- 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
- $1,464.75 / $3,010.91 / $3,906.77
| Facility | | $1,464.75 | $3,010.91 | $3,906.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,209.90 / $2,967.25 / $3,130.91
| Facility | | $2,209.90 | $2,967.25 | $3,130.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,104.19 / $2,104.19 / $2,135.56
| Facility | | $2,104.19 | $2,104.19 | $2,135.56 |
- 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 |