- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,258.93 / $1,412.54
| Facility | | $1,000.00 | $1,258.93 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $371.54 / $954.99
| Facility | | $199.53 | $371.54 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $16.98 / $32.36
| Facility | | $12.02 | $16.98 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $1,023.29 / $2,041.74
| Facility | | $302.00 | $1,023.29 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $3,467.37 / $3,467.37
| Facility | | $645.65 | $3,467.37 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $1,230.27 / $1,412.54
| Facility | | $323.59 | $1,230.27 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $1,698.24 / $2,454.71
| Facility | | $812.83 | $1,698.24 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $977.24 / $2,089.30
| Facility | | $338.84 | $977.24 | $2,089.30 |