- 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
- $1,276.43 / $3,062.18 / $4,875.76
| Facility | | $1,276.43 | $3,062.18 | $4,875.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $807.71 / $807.71 / $2,222.25
| Facility | | $807.71 | $807.71 | $2,222.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.47 / $789.64 / $1,056.85
| Facility | | $597.47 | $789.64 | $1,056.85 |
- 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 |