- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $8,317.64 / $11,481.54
| Facility | | $4,466.84 | $8,317.64 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $7,762.47 / $12,882.50
| Facility | | $4,786.30 | $7,762.47 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $8,912.51 / $12,302.69
| Facility | | $4,365.16 | $8,912.51 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $6,918.31 / $13,182.57
| Facility | | $3,311.31 | $6,918.31 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $7,079.46 / $12,882.50
| Facility | | $3,311.31 | $7,079.46 | $12,882.50 |