- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,593.60 / $6,582.61 / $9,320.27
| Facility | | $3,593.60 | $6,582.61 | $9,320.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,942.56 / $6,364.69 / $10,200.37
| Facility | | $3,942.56 | $6,364.69 | $10,200.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.26 / $6,702.00 / $10,535.12
| Facility | | $3,736.26 | $6,702.00 | $10,535.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $5,744.22 / $12,457.80
| Facility | | $3,308.00 | $5,744.22 | $12,457.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,773.89 / $5,917.41 / $11,070.65
| Facility | | $2,773.89 | $5,917.41 | $11,070.65 |