- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,187.76 / $14,454.40
| Facility | | $1,000.00 | $2,187.76 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,964.78 / $17,378.01
| Facility | | $6,606.93 | $10,964.78 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $3,235.94 / $5,370.32
| Facility | | $2,754.23 | $3,235.94 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,778.28 / $10,000.00
| Facility | | $1,047.13 | $1,778.28 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $2,187.76 / $15,135.61
| Facility | | $1,047.13 | $2,187.76 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,479.11 / $2,238.72 / $3,388.44
| Professional | | $1,479.11 | $2,238.72 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $11,748.98 / $17,782.79
| Facility | | $6,309.57 | $11,748.98 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $12,302.69 / $16,595.87
| Facility | | $7,585.78 | $12,302.69 | $16,595.87 |