- 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
- $2,423.61 / $8,392.32 / $13,362.65
| Facility | | $2,423.61 | $8,392.32 | $13,362.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $343.71 / $343.71 / $1,656.16
| Facility | | $343.71 | $343.71 | $1,656.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $253.83 / $334.05 / $465.87
| Facility | | $253.83 | $334.05 | $465.87 |
- 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 |