- 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
- $218.58 / $218.58 / $749.86
| Facility | | $218.58 | $218.58 | $749.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $182.63 / $227.59 / $295.14
| Facility | | $182.63 | $227.59 | $295.14 |
- 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 |