- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $3,981.07 / $8,317.64
| Facility | | $1,047.13 | $3,981.07 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $6,165.95 / $57,543.99
| Facility | | $5,011.87 | $6,165.95 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $6,918.31 / $6,918.31
| Facility | | $6,918.31 | $6,918.31 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,818.38 / $8,317.64
| Facility | | $954.99 | $2,818.38 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $204.17 / $363.08
| Facility | | $204.17 | $204.17 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.11 / $162.18 / $213.80
| Facility | | $33.11 | $162.18 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,548.13 / $10,000.00
| Facility | | $1,348.96 | $3,548.13 | $10,000.00 |