- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,801.89 / $12,882.50
| Facility | | $1,000.00 | $3,801.89 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $5,011.87 / $9,772.37
| Facility | | $2,884.03 | $5,011.87 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $3,235.94 / $3,235.94
| Facility | | $457.09 | $3,235.94 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $2,398.83 / $2,398.83
| Facility | | $2,398.83 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $33,884.42 / $33,884.42
| Facility | | $9,549.93 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $977.24 / $6,456.54
| Facility | | $512.86 | $977.24 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $676.08 / $1,174.90
| Facility | | $489.78 | $676.08 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,248.07 / $10,964.78
| Facility | | $1,698.24 | $5,248.07 | $10,964.78 |