- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,810.70 / $6,980.29 / $9,883.34
| Facility | | $3,810.70 | $6,980.29 | $9,883.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,344.22 / $7,061.96 / $11,395.41
| Facility | | $4,344.22 | $7,061.96 | $11,395.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,961.98 / $6,279.14 / $11,171.58
| Facility | | $3,961.98 | $6,279.14 | $11,171.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $6,121.26 / $13,210.42
| Facility | | $3,308.00 | $6,121.26 | $13,210.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,941.47 / $6,274.90 / $11,739.47
| Facility | | $2,941.47 | $6,274.90 | $11,739.47 |