- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $3,548.13 / $12,882.50
| Facility | | $575.44 | $3,548.13 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $1,230.27 / $2,238.72
| Facility | | $537.03 | $1,230.27 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $2,570.40 / $5,011.87
| Facility | | $407.38 | $2,570.40 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $309.03 / $309.03
| Facility | | $257.04 | $309.03 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $22,908.68 / $56,234.13
| Facility | | $10,000.00 | $22,908.68 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $7,585.78 / $7,585.78
| Facility | | $7,585.78 | $7,585.78 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $1,995.26 / $10,232.93
| Facility | | $309.03 | $1,995.26 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $389.05 / $11,220.18
| Facility | | $257.04 | $389.05 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $1,698.24 / $28,183.83
| Facility | | $162.18 | $1,698.24 | $28,183.83 |