- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $7,244.36 / $16,595.87
| Facility | | $1,000.00 | $7,244.36 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $4,265.80 / $7,943.28
| Facility | | $2,041.74 | $4,265.80 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $1,659.59
| Facility | | $501.19 | $501.19 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $446.68 / $724.44
| Facility | | $338.84 | $446.68 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $10,964.78 / $16,982.44
| Facility | | $1,995.26 | $10,964.78 | $16,982.44 |