- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,102.89 / $4,949.05 / $8,715.28
| Facility | | $3,102.89 | $4,949.05 | $8,715.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,451.65 / $3,721.44 / $5,832.28
| Facility | | $2,451.65 | $3,721.44 | $5,832.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,779.52 / $3,563.83 / $6,213.78
| Facility | | $1,779.52 | $3,563.83 | $6,213.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,313.00 / $3,695.50 / $6,553.44
| Facility | | $2,313.00 | $3,695.50 | $6,553.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,240.03 / $2,672.02 / $4,195.39
| Facility | | $1,240.03 | $2,672.02 | $4,195.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.96 / $3,024.97 / $4,885.17
| Facility | | $1,412.96 | $3,024.97 | $4,885.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,300.00 / $3,987.61 / $5,216.97
| Facility | | $2,300.00 | $3,987.61 | $5,216.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $710.00 / $1,538.46 / $5,272.12
| Facility | | $710.00 | $1,538.46 | $5,272.12 |