- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,635.19 / $8,311.86 / $13,383.20
| Facility | | $3,635.19 | $8,311.86 | $13,383.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,556.35 / $11,123.10
| Facility | | $1,474.01 | $5,556.35 | $11,123.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,016.72 / $8,690.58 / $12,311.26
| Facility | | $6,016.72 | $8,690.58 | $12,311.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,259.27 / $7,289.03 / $15,307.87
| Facility | | $5,259.27 | $7,289.03 | $15,307.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,937.91 / $7,289.03 / $15,505.52
| Facility | | $4,937.91 | $7,289.03 | $15,505.52 |