- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,175.54 / $5,672.82 / $8,262.00
| Facility | | $4,175.54 | $5,672.82 | $8,262.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,397.94 / $5,306.58 / $8,752.83
| Facility | | $3,397.94 | $5,306.58 | $8,752.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,642.62 / $5,028.85 / $9,102.00
| Facility | | $3,642.62 | $5,028.85 | $9,102.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.72 / $57.42 / $100.00
| Facility | | $38.72 | $57.42 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,012.16 / $5,552.68 / $9,138.41
| Facility | | $4,012.16 | $5,552.68 | $9,138.41 |