- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $7,838.38 / $7,838.38
| Facility | | $1,000.00 | $7,838.38 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,495.77 / $18,471.98 / $30,125.38
| Facility | | $7,495.77 | $18,471.98 | $30,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,247.19 / $1,247.19 / $3,388.59
| Facility | | $1,247.19 | $1,247.19 | $3,388.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $723.25 / $1,193.43 / $5,270.22
| Facility | | $723.25 | $1,193.43 | $5,270.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,002.00 / $15,131.00 / $25,517.86
| Facility | | $2,002.00 | $15,131.00 | $25,517.86 |