- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $6,606.93 / $10,232.93
| Facility | | $4,677.35 | $6,606.93 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $5,623.41 / $8,511.38
| Facility | | $3,801.89 | $5,623.41 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $7,762.47 / $10,471.29
| Facility | | $4,365.16 | $7,762.47 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $6,606.93 / $9,332.54
| Facility | | $4,265.80 | $6,606.93 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $4,365.16 / $7,244.36
| Facility | | $2,754.23 | $4,365.16 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $7,413.10 / $10,232.93
| Facility | | $4,168.69 | $7,413.10 | $10,232.93 |