- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $1,621.81 / $7,079.46
| Facility | | $1,621.81 | $1,621.81 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $9,549.93 / $26,915.35
| Facility | | $5,888.44 | $9,549.93 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $5,623.41 / $13,489.63
| Facility | | $3,981.07 | $5,623.41 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $5,370.32 / $10,715.19
| Facility | | $4,365.16 | $5,370.32 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,754.23 / $6,918.31
| Facility | | $1,513.56 | $2,754.23 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $6,456.54 / $10,715.19
| Facility | | $3,311.31 | $6,456.54 | $10,715.19 |