- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,561.00 / $6,225.56 / $12,654.70
| Facility | | $1,561.00 | $6,225.56 | $12,654.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,371.21 / $5,711.20 / $7,248.27
| Facility | | $2,371.21 | $5,711.20 | $7,248.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,645.53 / $5,823.27 / $6,657.50
| Facility | | $4,645.53 | $5,823.27 | $6,657.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,856.42 / $6,826.28 / $8,877.87
| Facility | | $3,856.42 | $6,826.28 | $8,877.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,670.44 / $4,249.25 / $8,194.06
| Facility | | $2,670.44 | $4,249.25 | $8,194.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,190.00 / $3,699.00 / $7,640.71
| Facility | | $1,190.00 | $3,699.00 | $7,640.71 |