- 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
- $6,369.58 / $9,962.39 / $15,625.45
| Facility | | $6,369.58 | $9,962.39 | $15,625.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,139.49 / $7,139.49 / $7,139.49
| Facility | | $7,139.49 | $7,139.49 | $7,139.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $797.69 / $1,126.65 / $8,986.49
| Facility | | $797.69 | $1,126.65 | $8,986.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,481.00 / $5,524.00 / $9,232.95
| Facility | | $1,481.00 | $5,524.00 | $9,232.95 |