- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,395.78 / $5,329.55 / $6,144.66
| Facility | | $4,395.78 | $5,329.55 | $6,144.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,040.51 / $6,522.63 / $10,586.06
| Facility | | $4,040.51 | $6,522.63 | $10,586.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $2,554.00 / $3,843.00
| Facility | | $1,252.00 | $2,554.00 | $3,843.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,910.36 / $6,224.21 / $10,682.70
| Facility | | $3,910.36 | $6,224.21 | $10,682.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,460.00 / $3,634.00 / $7,295.81
| Facility | | $1,460.00 | $3,634.00 | $7,295.81 |