- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,075.42 / $7,465.18 / $10,569.90
| Facility | | $4,075.42 | $7,465.18 | $10,569.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,971.31 / $8,162.99 / $13,162.80
| Facility | | $4,971.31 | $8,162.99 | $13,162.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,237.20 / $6,715.32 / $11,947.62
| Facility | | $4,237.20 | $6,715.32 | $11,947.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $6,553.61 / $14,128.08
| Facility | | $3,308.00 | $6,553.61 | $14,128.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,000.00 / $6,710.79 / $12,554.95
| Facility | | $3,000.00 | $6,710.79 | $12,554.95 |