- 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
- $2,419.71 / $8,378.81 / $13,341.15
| Facility | | $2,419.71 | $8,378.81 | $13,341.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.98 / $678.98 / $2,318.82
| Facility | | $678.98 | $678.98 | $2,318.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.92 / $656.91 / $880.92
| Facility | | $501.92 | $656.91 | $880.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.00 / $9,127.00 / $10,150.00
| Facility | | $1,230.00 | $9,127.00 | $10,150.00 |