- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,050.22 / $4,910.59 / $5,661.62
| Facility | | $4,050.22 | $4,910.59 | $5,661.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,098.34 / $9,164.26 / $11,537.38
| Facility | | $3,098.34 | $9,164.26 | $11,537.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,067.00 / $4,334.00
| Facility | | $1,252.00 | $3,067.00 | $4,334.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,602.96 / $5,734.92 / $9,842.91
| Facility | | $3,602.96 | $5,734.92 | $9,842.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $4,938.54 / $8,524.73
| Facility | | $2,332.00 | $4,938.54 | $8,524.73 |