- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,467.37 / $6,760.83
| Facility | | $1,000.00 | $3,467.37 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $8,912.51 / $14,454.40
| Facility | | $5,623.41 | $8,912.51 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $1,949.84 / $1,949.84
| Facility | | $1,949.84 | $1,949.84 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,096.48 / $5,888.44
| Facility | | $691.83 | $1,096.48 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $2,089.30 / $4,073.80
| Facility | | $616.60 | $2,089.30 | $4,073.80 |