- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $8,317.64 / $11,220.18
| Facility | | $3,235.94 | $8,317.64 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $9,120.11 / $15,135.61
| Facility | | $6,165.95 | $9,120.11 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $6,309.57 / $7,079.46
| Facility | | $4,570.88 | $6,309.57 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $8,709.64 / $12,302.69
| Facility | | $7,079.46 | $8,709.64 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $6,025.60 / $10,715.19
| Facility | | $1,819.70 | $6,025.60 | $10,715.19 |