- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,529.49 / $6,465.17 / $9,153.98
| Facility | | $3,529.49 | $6,465.17 | $9,153.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,812.51 / $7,670.96 / $13,754.93
| Facility | | $3,812.51 | $7,670.96 | $13,754.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,669.60 / $5,815.76 / $10,347.16
| Facility | | $3,669.60 | $5,815.76 | $10,347.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $5,720.46 / $12,235.54
| Facility | | $3,308.00 | $5,720.46 | $12,235.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,724.40 / $5,811.83 / $10,873.14
| Facility | | $2,724.40 | $5,811.83 | $10,873.14 |