- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,145.78 / $7,838.38
| Facility | | $1,000.00 | $2,145.78 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.45 / $3,318.09 / $5,411.38
| Facility | | $1,346.45 | $3,318.09 | $5,411.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $176.03 / $176.03 / $1,023.75
| Facility | | $176.03 | $176.03 | $1,023.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.25 / $170.00 / $264.95
| Facility | | $144.25 | $170.00 | $264.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $755.00 / $3,085.00 / $5,060.00
| Facility | | $755.00 | $3,085.00 | $5,060.00 |