- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,571.33 / $5,248.60 / $8,103.38
| Facility | | $3,571.33 | $5,248.60 | $8,103.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,726.99 / $9,563.42 / $12,260.79
| Facility | | $6,726.99 | $9,563.42 | $12,260.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,019.41 / $7,771.15 / $9,829.09
| Facility | | $4,019.41 | $7,771.15 | $9,829.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,571.33 / $5,368.41 / $8,584.31
| Facility | | $3,571.33 | $5,368.41 | $8,584.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,176.63 / $7,142.09 / $10,850.91
| Facility | | $4,176.63 | $7,142.09 | $10,850.91 |