- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,136.99 / $9,459.24 / $15,230.60
| Facility | | $4,136.99 | $9,459.24 | $15,230.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,930.56 / $12,823.38
| Facility | | $1,474.01 | $5,930.56 | $12,823.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,847.27 / $9,890.24 / $14,010.71
| Facility | | $6,847.27 | $9,890.24 | $14,010.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,985.27 / $8,295.21 / $17,420.98
| Facility | | $5,985.27 | $8,295.21 | $17,420.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,619.54 / $8,295.21 / $17,645.91
| Facility | | $5,619.54 | $8,295.21 | $17,645.91 |