- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,890.45 / $12,882.50
| Facility | | $1,000.00 | $3,890.45 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $4,073.80 / $7,762.47
| Facility | | $2,344.23 | $4,073.80 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $489.78 / $489.78
| Facility | | $489.78 | $489.78 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $6,165.95 / $6,165.95
| Facility | | $2,398.83 | $6,165.95 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $42,657.95 / $42,657.95
| Facility | | $9,549.93 | $42,657.95 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $1,000.00 / $6,025.60
| Facility | | $537.03 | $1,000.00 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $724.44 / $1,258.93
| Facility | | $501.19 | $724.44 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $4,073.80 / $8,709.64
| Facility | | $1,380.38 | $4,073.80 | $8,709.64 |