- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,497.56 / $8,238.44 / $11,664.70
| Facility | | $4,497.56 | $8,238.44 | $11,664.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,680.09 / $7,590.33 / $12,207.81
| Facility | | $4,680.09 | $7,590.33 | $12,207.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,676.10 / $7,410.91 / $13,185.19
| Facility | | $4,676.10 | $7,410.91 | $13,185.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,471.65 / $7,117.00 / $15,591.51
| Facility | | $3,471.65 | $7,117.00 | $15,591.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,000.00 / $7,224.57 / $13,855.43
| Facility | | $3,000.00 | $7,224.57 | $13,855.43 |