- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,373.77 / $8,011.69 / $11,343.70
| Facility | | $4,373.77 | $8,011.69 | $11,343.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,872.04 / $7,877.50 / $12,624.89
| Facility | | $4,872.04 | $7,877.50 | $12,624.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,547.39 / $7,206.94 / $12,822.29
| Facility | | $4,547.39 | $7,206.94 | $12,822.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,376.10 / $7,025.73 / $15,162.38
| Facility | | $3,376.10 | $7,025.73 | $15,162.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,000.00 / $7,025.73 / $13,474.08
| Facility | | $3,000.00 | $7,025.73 | $13,474.08 |