- 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
- $6,409.25 / $10,182.03 / $16,087.50
| Facility | | $6,409.25 | $10,182.03 | $16,087.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,627.83 / $7,627.83 / $7,627.83
| Facility | | $7,627.83 | $7,627.83 | $7,627.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $470.09 / $705.46 / $4,596.00
| Facility | | $470.09 | $705.46 | $4,596.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $884.00 / $2,900.00 / $5,543.93
| Facility | | $884.00 | $2,900.00 | $5,543.93 |