- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,690.97 / $4,475.02 / $5,159.43
| Facility | | $3,690.97 | $4,475.02 | $5,159.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,547.25 / $5,502.44 / $7,683.17
| Facility | | $3,547.25 | $5,502.44 | $7,683.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,067.00 / $4,334.00
| Facility | | $1,252.00 | $3,067.00 | $4,334.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,283.38 / $5,226.24 / $8,969.85
| Facility | | $3,283.38 | $5,226.24 | $8,969.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $4,828.00 / $7,768.59
| Facility | | $2,332.00 | $4,828.00 | $7,768.59 |