- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.82 / $6,964.01 / $9,860.29
| Facility | | $3,801.82 | $6,964.01 | $9,860.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,689.24 / $5,960.15 / $9,810.01
| Facility | | $3,689.24 | $5,960.15 | $9,810.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,952.74 / $8,001.30 / $15,283.00
| Facility | | $3,952.74 | $8,001.30 | $15,283.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $6,077.04 / $13,761.46
| Facility | | $3,308.00 | $6,077.04 | $13,761.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,934.61 / $6,587.90 / $13,179.61
| Facility | | $2,934.61 | $6,587.90 | $13,179.61 |