- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $7,838.38 / $7,838.38
| Facility | | $1,000.00 | $7,838.38 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,345.93 / $15,048.81 / $23,961.46
| Facility | | $4,345.93 | $15,048.81 | $23,961.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,121.54 / $1,121.54 / $3,456.15
| Facility | | $1,121.54 | $1,121.54 | $3,456.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.07 / $1,087.65 / $1,459.75
| Facility | | $478.07 | $1,087.65 | $1,459.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $936.00 / $6,599.00 / $7,158.00
| Facility | | $936.00 | $6,599.00 | $7,158.00 |