- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,779.00 / $12,600.00
| Facility | | $1,000.00 | $3,779.00 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,878.46 / $6,161.50 / $9,735.10
| Facility | | $3,878.46 | $6,161.50 | $9,735.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,581.62 / $1,581.62 / $1,581.62
| Facility | | $1,581.62 | $1,581.62 | $1,581.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $510.50 / $730.02 / $4,244.47
| Facility | | $510.50 | $730.02 | $4,244.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $884.00 / $3,248.40 / $5,543.93
| Facility | | $884.00 | $3,248.40 | $5,543.93 |