- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,379.47 / $8,022.16 / $11,358.50
| Facility | | $4,379.47 | $8,022.16 | $11,358.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,328.30 / $8,726.31 / $14,081.05
| Facility | | $5,328.30 | $8,726.31 | $14,081.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,553.34 / $7,216.35 / $12,839.04
| Facility | | $4,553.34 | $7,216.35 | $12,839.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,380.51 / $7,117.00 / $15,182.19
| Facility | | $3,380.51 | $7,117.00 | $15,182.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,000.00 / $7,117.00 / $13,491.68
| Facility | | $3,000.00 | $7,117.00 | $13,491.68 |