- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,683.00 / $8,400.00
| Facility | | $1,000.00 | $3,683.00 | $8,400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,794.37 / $6,060.22 / $9,577.03
| Facility | | $3,794.37 | $6,060.22 | $9,577.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,491.09 / $1,491.09 / $1,491.09
| Facility | | $1,491.09 | $1,491.09 | $1,491.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.52 / $586.08 / $5,246.20
| Facility | | $363.52 | $586.08 | $5,246.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $942.00 / $3,710.26 / $5,847.50
| Facility | | $942.00 | $3,710.26 | $5,847.50 |