- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $5,000.27 / $7,838.38
| Facility | | $1,000.00 | $5,000.27 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,742.88 / $4,427.60 / $7,214.72
| Facility | | $1,742.88 | $4,427.60 | $7,214.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.92 / $124.92 / $1,042.07
| Facility | | $124.92 | $124.92 | $1,042.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.81 / $125.76 / $190.87
| Facility | | $103.81 | $125.76 | $190.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $559.00 / $3,503.00 / $5,060.00
| Facility | | $559.00 | $3,503.00 | $5,060.00 |