- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,661.73 / $5,522.76 / $7,408.30
| Facility | | $2,661.73 | $5,522.76 | $7,408.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,154.00 / $5,658.46 / $7,847.65
| Facility | | $5,154.00 | $5,658.46 | $7,847.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $5,556.29 / $6,606.69
| Facility | | $2,651.00 | $5,556.29 | $6,606.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,694.35 / $5,702.85 / $8,976.11
| Facility | | $4,694.35 | $5,702.85 | $8,976.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,372.00 / $7,045.72
| Facility | | $1,350.00 | $5,372.00 | $7,045.72 |