- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,187.41 / $2,733.00 / $4,806.64
| Facility | | $1,187.41 | $2,733.00 | $4,806.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $487.47 / $4,402.00 / $7,608.00
| Facility | | $487.47 | $4,402.00 | $7,608.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $227.89 / $296.26 / $582.26
| Facility | | $227.89 | $296.26 | $582.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $196.17 / $304.56 / $6,679.00
| Facility | | $196.17 | $304.56 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,616.20 / $3,616.20 / $11,820.92
| Facility | | $3,616.20 | $3,616.20 | $11,820.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $4,287.00 / $9,401.00
| Facility | | $55.00 | $4,287.00 | $9,401.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $4,983.00 / $8,810.00
| Facility | | $2,155.00 | $4,983.00 | $8,810.00 |