- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,056.67 / $5,228.50 / $10,625.70
| Facility | | $4,056.67 | $5,228.50 | $10,625.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,697.32 / $3,910.74 / $5,167.43
| Facility | | $3,697.32 | $3,910.74 | $5,167.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,926.30 / $4,921.70 / $5,626.78
| Facility | | $3,926.30 | $4,921.70 | $5,626.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,238.09 / $5,731.76 / $7,454.40
| Facility | | $3,238.09 | $5,731.76 | $7,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,251.92 / $4,685.30 / $6,896.18
| Facility | | $4,251.92 | $4,685.30 | $6,896.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $4,596.72 / $7,079.08
| Facility | | $1,286.00 | $4,596.72 | $7,079.08 |