- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,462.29 / $5,410.18 / $6,237.62
| Facility | | $4,462.29 | $5,410.18 | $6,237.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,363.85 / $6,769.13 / $9,888.94
| Facility | | $4,363.85 | $6,769.13 | $9,888.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $2,554.00 / $3,843.00
| Facility | | $1,252.00 | $2,554.00 | $3,843.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,969.52 / $6,318.38 / $10,844.32
| Facility | | $3,969.52 | $6,318.38 | $10,844.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,044.00 / $9,392.02
| Facility | | $2,332.00 | $5,044.00 | $9,392.02 |