- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,779.00 / $12,600.00
| Facility | | $1,000.00 | $3,779.00 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,873.50 / $12,508.22 / $19,762.84
| Facility | | $7,873.50 | $12,508.22 | $19,762.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,117.62 / $8,117.62 / $8,117.62
| Facility | | $8,117.62 | $8,117.62 | $8,117.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $735.48 / $1,015.98 / $4,596.00
| Facility | | $735.48 | $1,015.98 | $4,596.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $886.00 / $3,317.00 / $5,543.93
| Facility | | $886.00 | $3,317.00 | $5,543.93 |