- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,488.37 / $5,441.80 / $6,274.08
| Facility | | $4,488.37 | $5,441.80 | $6,274.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,371.01 / $3,371.01 / $6,712.26
| Facility | | $3,371.01 | $3,371.01 | $6,712.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,067.00 / $4,334.00
| Facility | | $1,252.00 | $3,067.00 | $4,334.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,992.72 / $6,355.31 / $10,907.70
| Facility | | $3,992.72 | $6,355.31 | $10,907.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,044.00 / $9,446.91
| Facility | | $2,332.00 | $5,044.00 | $9,446.91 |