- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,977.69 / $6,808.48 / $10,966.50
| Facility | | $2,977.69 | $6,808.48 | $10,966.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,856.67 / $5,931.48 / $7,646.64
| Facility | | $4,856.67 | $5,931.48 | $7,646.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $4,504.02 / $9,383.79
| Facility | | $1,474.01 | $4,504.02 | $9,383.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,928.47 / $7,405.72 / $12,605.91
| Facility | | $4,928.47 | $7,405.72 | $12,605.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,308.02 / $5,970.66 / $12,918.00
| Facility | | $4,308.02 | $5,970.66 | $12,918.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,044.78 / $5,970.66 / $12,701.02
| Facility | | $4,044.78 | $5,970.66 | $12,701.02 |