- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,218.00 / $8,400.00
| Facility | | $1,000.00 | $3,218.00 | $8,400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,719.49 / $2,739.02 / $4,373.29
| Facility | | $1,719.49 | $2,739.02 | $4,373.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,070.25 / $1,070.25 / $1,070.25
| Facility | | $1,070.25 | $1,070.25 | $1,070.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.38 / $1,807.00 / $5,819.45
| Facility | | $393.38 | $1,807.00 | $5,819.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $884.00 / $2,900.00 / $5,543.93
| Facility | | $884.00 | $2,900.00 | $5,543.93 |