- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,715.35 / $12,882.50
| Facility | | $1,000.00 | $3,715.35 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,691.53 / $6,165.95
| Facility | | $1,096.48 | $2,691.53 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $138.04 / $144.54
| Facility | | $138.04 | $138.04 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $33,884.42 / $33,884.42
| Facility | | $2,511.89 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $549.54 / $5,370.32
| Facility | | $158.49 | $549.54 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $323.59 / $645.65
| Facility | | $165.96 | $323.59 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $1,047.13 / $2,691.53
| Facility | | $154.88 | $1,047.13 | $2,691.53 |