- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,344.57 / $7,958.20 / $11,268.00
| Facility | | $4,344.57 | $7,958.20 | $11,268.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,103.76 / $8,353.79 / $13,486.58
| Facility | | $5,103.76 | $8,353.79 | $13,486.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,517.04 / $7,158.82 / $12,736.68
| Facility | | $4,517.04 | $7,158.82 | $12,736.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,353.56 / $7,019.93 / $15,061.15
| Facility | | $3,353.56 | $7,019.93 | $15,061.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,000.00 / $7,117.00 / $13,384.13
| Facility | | $3,000.00 | $7,117.00 | $13,384.13 |