- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,742.00 / $18,600.00
| Facility | | $1,000.00 | $3,742.00 | $18,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,444.76 / $15,004.39 / $23,706.76
| Facility | | $9,444.76 | $15,004.39 | $23,706.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,792.00 / $5,792.00 / $5,792.00
| Facility | | $5,792.00 | $5,792.00 | $5,792.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $291.58 / $477.79 / $5,415.32
| Facility | | $291.58 | $477.79 | $5,415.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $350.00 / $1,760.00 / $6,155.68
| Facility | | $350.00 | $1,760.00 | $6,155.68 |