- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,803.00 / $12,600.00
| Facility | | $1,000.00 | $3,803.00 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,602.87 / $8,785.64 / $13,706.31
| Facility | | $5,602.87 | $8,785.64 | $13,706.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,545.78 / $2,545.78 / $2,545.78
| Facility | | $2,545.78 | $2,545.78 | $2,545.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $493.61 / $743.00 / $6,840.79
| Facility | | $493.61 | $743.00 | $6,840.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,157.00 / $4,054.00 / $7,077.94
| Facility | | $1,157.00 | $4,054.00 | $7,077.94 |