- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,984.64 / $7,298.90 / $10,334.50
| Facility | | $3,984.64 | $7,298.90 | $10,334.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,428.09 / $8,761.52 / $14,519.42
| Facility | | $5,428.09 | $8,761.52 | $14,519.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,142.82 / $6,565.74 / $11,681.50
| Facility | | $4,142.82 | $6,565.74 | $11,681.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $6,369.27 / $13,813.39
| Facility | | $3,308.00 | $6,369.27 | $13,813.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,000.00 / $6,400.66 / $12,275.30
| Facility | | $3,000.00 | $6,400.66 | $12,275.30 |