- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.85 / $7,814.02 / $11,063.80
| Facility | | $4,265.85 | $7,814.02 | $11,063.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,204.28 / $6,863.84 / $11,315.29
| Facility | | $4,204.28 | $6,863.84 | $11,315.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,435.20 / $7,029.12 / $12,505.92
| Facility | | $4,435.20 | $7,029.12 | $12,505.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $6,631.97 / $14,788.27
| Facility | | $3,308.00 | $6,631.97 | $14,788.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,000.00 / $7,024.38 / $13,141.63
| Facility | | $3,000.00 | $7,024.38 | $13,141.63 |