- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,742.00 / $12,600.00
| Facility | | $1,000.00 | $3,742.00 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,653.03 / $7,392.01 / $11,679.29
| Facility | | $4,653.03 | $7,392.01 | $11,679.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,659.86 / $5,659.86 / $5,659.86
| Facility | | $5,659.86 | $5,659.86 | $5,659.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.79 / $568.24 / $4,596.00
| Facility | | $382.79 | $568.24 | $4,596.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $886.00 / $3,680.00 / $5,962.62
| Facility | | $886.00 | $3,680.00 | $5,962.62 |