- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,324.32 / $7,601.06 / $12,238.70
| Facility | | $3,324.32 | $7,601.06 | $12,238.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,649.92 / $12,051.30
| Facility | | $1,474.01 | $6,649.92 | $12,051.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,502.19 / $7,947.40 / $11,258.45
| Facility | | $5,502.19 | $7,947.40 | $11,258.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,809.52 / $6,665.70 / $13,998.80
| Facility | | $4,809.52 | $6,665.70 | $13,998.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,515.64 / $6,665.70 / $14,179.55
| Facility | | $4,515.64 | $6,665.70 | $14,179.55 |