- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,480.56 / $5,115.20 / $7,897.42
| Facility | | $3,480.56 | $5,115.20 | $7,897.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,926.31 / $7,003.48 / $8,978.82
| Facility | | $4,926.31 | $7,003.48 | $8,978.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,917.25 / $7,573.63 / $9,579.27
| Facility | | $3,917.25 | $7,573.63 | $9,579.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,480.56 / $5,231.96 / $8,366.12
| Facility | | $3,480.56 | $5,231.96 | $8,366.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,070.48 / $6,960.56 / $10,575.12
| Facility | | $4,070.48 | $6,960.56 | $10,575.12 |