- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,650.72 / $5,994.16 / $12,181.70
| Facility | | $4,650.72 | $5,994.16 | $12,181.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,424.96 / $7,188.81 / $7,335.01
| Facility | | $4,424.96 | $7,188.81 | $7,335.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,597.25 / $5,762.75 / $6,588.31
| Facility | | $4,597.25 | $5,762.75 | $6,588.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,712.28 / $6,571.13 / $8,546.03
| Facility | | $3,712.28 | $6,571.13 | $8,546.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,088.70 / $5,088.70 / $8,267.12
| Facility | | $5,088.70 | $5,088.70 | $8,267.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $5,269.88 / $8,115.75
| Facility | | $1,286.00 | $5,269.88 | $8,115.75 |