- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,570.40 / $6,309.57
| Facility | | $1,000.00 | $2,570.40 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,412.54 / $3,235.94
| Facility | | $724.44 | $1,412.54 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $2,511.89 / $2,511.89
| Facility | | $2,511.89 | $2,511.89 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $218.78 / $2,290.87
| Facility | | $138.04 | $218.78 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,445.44 / $3,019.95
| Facility | | $1,071.52 | $1,445.44 | $3,019.95 |