- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $4,192.00 / $12,186.41
| Facility | | $1,000.00 | $4,192.00 | $12,186.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,873.50 / $12,575.25 / $19,872.87
| Facility | | $7,873.50 | $12,575.25 | $19,872.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,545.78 / $2,545.78 / $2,545.78
| Facility | | $2,545.78 | $2,545.78 | $2,545.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $615.71 / $846.60 / $5,962.62
| Facility | | $615.71 | $846.60 | $5,962.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $886.00 / $3,317.00 / $5,543.93
| Facility | | $886.00 | $3,317.00 | $5,543.93 |