- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $5,248.07 / $12,882.50
| Facility | | $1,000.00 | $5,248.07 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,786.30 / $10,232.93
| Facility | | $2,630.27 | $4,786.30 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $3,467.37 / $13,489.63
| Facility | | $933.25 | $3,467.37 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,412.54 / $50,118.72
| Facility | | $1,122.02 | $1,412.54 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $741.31 / $2,238.72
| Facility | | $616.60 | $741.31 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $50,118.72 / $75,857.76
| Facility | | $602.56 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $4,365.16 / $9,549.93
| Facility | | $1,905.46 | $4,365.16 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $912.01 / $1,819.70
| Facility | | $549.54 | $912.01 | $1,819.70 |