- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $7,838.38 / $8,644.27
| Facility | | $1,000.00 | $7,838.38 | $8,644.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,800.17 / $11,192.51 / $17,821.25
| Facility | | $3,800.17 | $11,192.51 | $17,821.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $689.98 / $689.98 / $1,996.40
| Facility | | $689.98 | $689.98 | $1,996.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $565.17 / $709.04 / $931.60
| Facility | | $565.17 | $709.04 | $931.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,092.00 / $9,127.00 / $9,127.00
| Facility | | $2,092.00 | $9,127.00 | $9,127.00 |