- 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
- $1,276.43 / $3,062.18 / $4,875.76
| Facility | | $1,276.43 | $3,062.18 | $4,875.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $440.62 / $440.62 / $5,091.89
| Facility | | $440.62 | $440.62 | $5,091.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $367.30 / $484.47 / $630.00
| Facility | | $367.30 | $484.47 | $630.00 |
- 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 |