- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,400.37 / $7,056.72 / $11,715.80
| Facility | | $5,400.37 | $7,056.72 | $11,715.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,169.52 / $6,382.87 / $10,731.27
| Facility | | $4,169.52 | $6,382.87 | $10,731.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,082.67 / $7,713.75 / $12,152.00
| Facility | | $6,082.67 | $7,713.75 | $12,152.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,952.00 / $7,587.31 / $18,644.45
| Facility | | $3,952.00 | $7,587.31 | $18,644.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,952.00 / $7,395.52 / $10,139.79
| Facility | | $3,952.00 | $7,395.52 | $10,139.79 |