- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,730.60 / $3,982.13 / $6,464.24
| Facility | | $2,730.60 | $3,982.13 | $6,464.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,064.72 / $10,043.54 / $12,876.35
| Facility | | $7,064.72 | $10,043.54 | $12,876.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,206.37 / $6,199.21 / $7,840.88
| Facility | | $3,206.37 | $6,199.21 | $7,840.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,848.93 / $4,282.49 / $6,847.89
| Facility | | $2,848.93 | $4,282.49 | $6,847.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,331.79 / $5,697.40 / $8,656.00
| Facility | | $3,331.79 | $5,697.40 | $8,656.00 |