- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,888.71 / $5,715.04 / $8,823.53
| Facility | | $3,888.71 | $5,715.04 | $8,823.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,668.33 / $7,876.89 / $8,667.00
| Facility | | $7,668.33 | $7,876.89 | $8,667.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,866.63 / $9,761.93 / $12,515.30
| Facility | | $6,866.63 | $9,761.93 | $12,515.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,376.60 / $8,461.76 / $10,702.60
| Facility | | $4,376.60 | $8,461.76 | $10,702.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,888.71 / $5,845.49 / $9,347.20
| Facility | | $3,888.71 | $5,845.49 | $9,347.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,547.81 / $7,776.80 / $11,815.22
| Facility | | $4,547.81 | $7,776.80 | $11,815.22 |