- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,093.47 / $7,888.25 / $8,922.69
| Facility | | $5,093.47 | $7,888.25 | $8,922.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,923.18 / $7,446.17 / $10,056.62
| Facility | | $4,923.18 | $7,446.17 | $10,056.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,703.46 / $7,257.93 / $11,081.69
| Facility | | $4,703.46 | $7,257.93 | $11,081.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,156.00 / $8,309.00 / $19,082.00
| Facility | | $5,156.00 | $8,309.00 | $19,082.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $9,477.00 / $12,098.83
| Facility | | $5,274.00 | $9,477.00 | $12,098.83 |