- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,576.00 / $8,400.00
| Facility | | $1,000.00 | $3,576.00 | $8,400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,369.58 / $9,962.39 / $15,625.45
| Facility | | $6,369.58 | $9,962.39 | $15,625.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,272.32 / $7,272.32 / $7,272.32
| Facility | | $7,272.32 | $7,272.32 | $7,272.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $579.79 / $879.92 / $6,889.15
| Facility | | $579.79 | $879.92 | $6,889.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,157.00 / $4,424.00 / $7,077.94
| Facility | | $1,157.00 | $4,424.00 | $7,077.94 |