- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,301.75 / $5,544.37 / $11,267.60
| Facility | | $4,301.75 | $5,544.37 | $11,267.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,642.00 / $4,095.80 / $7,403.52
| Facility | | $2,642.00 | $4,095.80 | $7,403.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,320.35 / $5,415.65 / $6,191.49
| Facility | | $4,320.35 | $5,415.65 | $6,191.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,433.72 / $6,078.04 / $7,904.75
| Facility | | $3,433.72 | $6,078.04 | $7,904.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,038.30 / $4,710.17 / $8,514.04
| Facility | | $3,038.30 | $4,710.17 | $8,514.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $5,273.64 / $7,506.75
| Facility | | $1,286.00 | $5,273.64 | $7,506.75 |