- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $6,165.95 / $11,220.18
| Facility | | $1,000.00 | $6,165.95 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $13,803.84 / $19,054.61
| Facility | | $3,715.35 | $13,803.84 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $660.69 / $741.31
| Facility | | $630.96 | $660.69 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $1,047.13 / $1,348.96
| Facility | | $660.69 | $1,047.13 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $6,025.60 / $10,715.19
| Facility | | $2,398.83 | $6,025.60 | $10,715.19 |