- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $8,317.64 / $14,454.40
| Facility | | $6,025.60 | $8,317.64 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $7,413.10 / $11,748.98
| Facility | | $4,677.35 | $7,413.10 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $7,244.36 / $12,882.50
| Facility | | $5,128.61 | $7,244.36 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $85.11 / $128.82
| Facility | | $56.23 | $85.11 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $8,128.31 / $11,748.98
| Facility | | $5,623.41 | $8,128.31 | $11,748.98 |