- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,630.27 / $6,606.93
| Facility | | $1,000.00 | $2,630.27 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $11,481.54 / $19,054.61
| Facility | | $7,413.10 | $11,481.54 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $5,623.41 / $5,623.41
| Facility | | $5,623.41 | $5,623.41 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $1,071.52 / $5,888.44
| Facility | | $660.69 | $1,071.52 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $3,311.31 / $6,165.95
| Facility | | $891.25 | $3,311.31 | $6,165.95 |