- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,888.33 / $11,627.00
| Facility | | $1,000.00 | $3,888.33 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,405.00 / $7,949.51 / $14,996.00
| Facility | | $3,405.00 | $7,949.51 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $984.25 / $1,181.09 / $1,461.87
| Facility | | $984.25 | $1,181.09 | $1,461.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,480.00 / $3,086.00 / $6,111.00
| Facility | | $1,480.00 | $3,086.00 | $6,111.00 |