- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $5,248.07 / $6,025.60
| Facility | | $4,073.80 | $5,248.07 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $5,623.41 / $8,128.31
| Facility | | $3,981.07 | $5,623.41 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $4,570.88 / $5,495.41
| Facility | | $3,890.45 | $4,570.88 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $6,025.60 / $7,413.10
| Facility | | $3,715.35 | $6,025.60 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $6,456.54 / $9,772.37
| Facility | | $4,570.88 | $6,456.54 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $5,495.41 / $7,079.46
| Facility | | $1,513.56 | $5,495.41 | $7,079.46 |