- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,898.30 / $5,024.38 / $10,210.90
| Facility | | $3,898.30 | $5,024.38 | $10,210.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,268.14 / $5,455.27 / $6,285.61
| Facility | | $4,268.14 | $5,455.27 | $6,285.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,968.90 / $4,975.10 / $5,687.83
| Facility | | $3,968.90 | $4,975.10 | $5,687.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,111.68 / $5,508.00 / $7,163.39
| Facility | | $3,111.68 | $5,508.00 | $7,163.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,908.37 / $6,273.56 / $8,982.07
| Facility | | $4,908.37 | $6,273.56 | $8,982.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $4,417.28 / $6,802.72
| Facility | | $1,286.00 | $4,417.28 | $6,802.72 |