- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,451.52 / $5,737.40 / $11,659.90
| Facility | | $4,451.52 | $5,737.40 | $11,659.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,084.36 / $6,529.85 / $6,858.83
| Facility | | $4,084.36 | $6,529.85 | $6,858.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,419.75 / $5,540.25 / $6,333.94
| Facility | | $4,419.75 | $5,540.25 | $6,333.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,553.26 / $6,289.65 / $8,179.96
| Facility | | $3,553.26 | $6,289.65 | $8,179.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,697.01 / $7,509.33 / $7,887.65
| Facility | | $4,697.01 | $7,509.33 | $7,887.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $5,044.14 / $7,768.11
| Facility | | $1,286.00 | $5,044.14 | $7,768.11 |