- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $4,897.79 / $11,220.18
| Facility | | $1,000.00 | $4,897.79 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $28,183.83 / $39,810.72
| Facility | | $4,168.69 | $28,183.83 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $676.08 / $776.25
| Facility | | $616.60 | $676.08 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $1,174.90 / $1,698.24
| Facility | | $741.31 | $1,174.90 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $9,549.93 / $16,218.10
| Facility | | $4,466.84 | $9,549.93 | $16,218.10 |