- 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
- $1,844.86 / $4,546.33 / $7,414.46
| Facility | | $1,844.86 | $4,546.33 | $7,414.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.47 / $141.47 / $1,023.75
| Facility | | $141.47 | $141.47 | $1,023.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.28 / $212.38 / $1,387.29
| Facility | | $79.28 | $212.38 | $1,387.29 |
- 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 |