- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,387.10 / $8,036.11 / $11,378.30
| Facility | | $4,387.10 | $8,036.11 | $11,378.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,645.29 / $7,531.26 / $12,069.99
| Facility | | $4,645.29 | $7,531.26 | $12,069.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,561.26 / $7,228.91 / $12,861.37
| Facility | | $4,561.26 | $7,228.91 | $12,861.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,386.39 / $7,012.59 / $15,208.60
| Facility | | $3,386.39 | $7,012.59 | $15,208.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,000.00 / $7,117.00 / $13,515.15
| Facility | | $3,000.00 | $7,117.00 | $13,515.15 |