- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,062.00 / $6,681.00
| Facility | | $1,000.00 | $3,062.00 | $6,681.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,678.00 / $3,611.00 / $5,878.00
| Facility | | $1,678.00 | $3,611.00 | $5,878.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $545.70 / $1,759.11 / $3,125.00
| Facility | | $545.70 | $1,759.11 | $3,125.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,698.80 / $7,929.30 / $26,542.00
| Facility | | $2,698.80 | $7,929.30 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,351.00 / $6,285.00
| Facility | | $1,000.00 | $3,351.00 | $6,285.00 |