- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,683.00 / $8,400.00
| Facility | | $1,000.00 | $3,683.00 | $8,400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,271.00 / $9,962.39 / $15,740.47
| Facility | | $6,271.00 | $9,962.39 | $15,740.47 |
- 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
- $627.60 / $886.68 / $5,543.93
| Facility | | $627.60 | $886.68 | $5,543.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $884.00 / $3,363.00 / $6,167.00
| Facility | | $884.00 | $3,363.00 | $6,167.00 |