- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.00 / $4,640.82 / $10,475.15
| Facility | | $1,548.00 | $4,640.82 | $10,475.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,385.00 / $4,133.00 / $9,074.00
| Facility | | $2,385.00 | $4,133.00 | $9,074.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,668.47 / $2,390.00 / $10,957.50
| Facility | | $1,668.47 | $2,390.00 | $10,957.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,325.00 / $1,325.00 / $1,685.80
| Facility | | $1,325.00 | $1,325.00 | $1,685.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.00 / $1,337.51 / $3,009.40
| Facility | | $332.00 | $1,337.51 | $3,009.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $1,325.00 / $74,999.25
| Facility | | $555.00 | $1,325.00 | $74,999.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,652.00 / $4,370.00 / $9,187.00
| Facility | | $1,652.00 | $4,370.00 | $9,187.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,619.12 / $1,619.12 / $3,980.90
| Facility | | $1,619.12 | $1,619.12 | $3,980.90 |