- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,509.64 / $5,207.20 / $6,985.01
| Facility | | $2,509.64 | $5,207.20 | $6,985.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,383.72 / $5,212.64 / $6,287.98
| Facility | | $3,383.72 | $5,212.64 | $6,287.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $4,904.39 / $5,831.56
| Facility | | $2,651.00 | $4,904.39 | $5,831.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,426.12 / $5,377.00 / $8,463.23
| Facility | | $4,426.12 | $5,377.00 | $8,463.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,372.00 / $6,771.06
| Facility | | $1,350.00 | $5,372.00 | $6,771.06 |