- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,024.63 / $7,372.15 / $10,438.20
| Facility | | $4,024.63 | $7,372.15 | $10,438.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,774.37 / $7,622.01 / $12,012.02
| Facility | | $4,774.37 | $7,622.01 | $12,012.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,184.39 / $8,470.24 / $12,028.00
| Facility | | $4,184.39 | $8,470.24 | $12,028.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $6,627.16 / $13,952.03
| Facility | | $3,308.00 | $6,627.16 | $13,952.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,000.00 / $6,627.16 / $12,398.50
| Facility | | $3,000.00 | $6,627.16 | $12,398.50 |