- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,543.79 / $4,953.38 / $8,040.88
| Facility | | $3,543.79 | $4,953.38 | $8,040.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,373.83 / $7,436.61 / $8,109.30
| Facility | | $5,373.83 | $7,436.61 | $8,109.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,939.69 / $9,865.81 / $12,648.48
| Facility | | $6,939.69 | $9,865.81 | $12,648.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,988.41 / $7,711.21 / $9,753.29
| Facility | | $3,988.41 | $7,711.21 | $9,753.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,543.79 / $5,327.00 / $8,518.11
| Facility | | $3,543.79 | $5,327.00 | $8,518.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,144.42 / $7,087.01 / $10,767.22
| Facility | | $4,144.42 | $7,087.01 | $10,767.22 |