- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $389.05 / $5,495.41
| Facility | | $389.05 | $389.05 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $10,000.00 / $23,442.29
| Facility | | $5,623.41 | $10,000.00 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,479.11 / $3,548.13
| Facility | | $1,047.13 | $1,479.11 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,412.54 / $2,754.23
| Facility | | $1,148.15 | $1,412.54 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $831.76 / $10,964.78
| Facility | | $489.78 | $831.76 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $8,709.64 / $13,489.63
| Facility | | $3,311.31 | $8,709.64 | $13,489.63 |