- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,429.20 / $6,459.25 / $10,485.40
| Facility | | $4,429.20 | $6,459.25 | $10,485.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,014.06 / $7,014.06 / $9,721.11
| Facility | | $7,014.06 | $7,014.06 | $9,721.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,803.10 / $8,249.98 / $10,576.90
| Facility | | $5,803.10 | $8,249.98 | $10,576.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,200.92 / $10,055.49 / $12,718.38
| Facility | | $5,200.92 | $10,055.49 | $12,718.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,621.13 / $6,946.46 / $11,107.70
| Facility | | $4,621.13 | $6,946.46 | $11,107.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,404.36 / $9,241.53 / $14,040.56
| Facility | | $5,404.36 | $9,241.53 | $14,040.56 |