- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,497.50 / $3,596.16 / $5,744.25
| Facility | | $2,497.50 | $3,596.16 | $5,744.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,944.00 / $4,226.17 / $7,373.62
| Facility | | $1,944.00 | $4,226.17 | $7,373.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,047.33 / $5,050.57 / $8,980.62
| Facility | | $3,047.33 | $5,050.57 | $8,980.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,240.03 / $2,677.32 / $4,195.39
| Facility | | $1,240.03 | $2,677.32 | $4,195.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,944.00 / $4,311.12 / $6,756.95
| Facility | | $1,944.00 | $4,311.12 | $6,756.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,782.22 / $3,856.14 / $5,012.84
| Facility | | $2,782.22 | $3,856.14 | $5,012.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $800.00 / $3,313.68 / $5,359.04
| Facility | | $800.00 | $3,313.68 | $5,359.04 |