- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,051.53 / $4,912.17 / $5,663.44
| Facility | | $4,051.53 | $4,912.17 | $5,663.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,458.01 / $6,159.86 / $15,674.36
| Facility | | $5,458.01 | $6,159.86 | $15,674.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $2,554.00 / $3,843.00
| Facility | | $1,252.00 | $2,554.00 | $3,843.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,604.12 / $5,736.76 / $9,846.08
| Facility | | $3,604.12 | $5,736.76 | $9,846.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $4,940.13 / $8,527.46
| Facility | | $2,332.00 | $4,940.13 | $8,527.46 |