- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,452.95 / $5,739.25 / $11,663.70
| Facility | | $4,452.95 | $5,739.25 | $11,663.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,323.31 / $6,245.08 / $7,109.50
| Facility | | $4,323.31 | $6,245.08 | $7,109.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,370.76 / $5,478.84 / $6,263.73
| Facility | | $4,370.76 | $5,478.84 | $6,263.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,554.41 / $6,291.68 / $8,182.60
| Facility | | $3,554.41 | $6,291.68 | $8,182.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,971.81 / $7,181.84 / $8,066.89
| Facility | | $4,971.81 | $7,181.84 | $8,066.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $5,045.77 / $7,770.61
| Facility | | $1,286.00 | $5,045.77 | $7,770.61 |