- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,000.00 / $6,760.83
| Facility | | $1,000.00 | $1,000.00 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $3,801.89 / $8,317.64
| Facility | | $2,454.71 | $3,801.89 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $3,715.35 / $8,709.64
| Facility | | $2,630.27 | $3,715.35 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $3,548.13 / $6,918.31
| Facility | | $2,818.38 | $3,548.13 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,659.59 / $4,365.16
| Facility | | $1,000.00 | $1,659.59 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $4,265.80 / $6,760.83
| Facility | | $2,691.53 | $4,265.80 | $6,760.83 |