- 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
- $1,328.81 / $3,187.83 / $5,075.81
| Facility | | $1,328.81 | $3,187.83 | $5,075.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $341.86 / $341.86 / $749.86
| Facility | | $341.86 | $341.86 | $749.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $285.29 / $439.22 / $547.13
| Facility | | $285.29 | $439.22 | $547.13 |
- 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 |