- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,394.09 / $8,048.90 / $11,396.40
| Facility | | $4,394.09 | $8,048.90 | $11,396.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,331.03 / $8,705.33 / $14,207.16
| Facility | | $5,331.03 | $8,705.33 | $14,207.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,568.52 / $9,247.79 / $16,763.70
| Facility | | $4,568.52 | $9,247.79 | $16,763.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,391.78 / $7,235.53 / $15,460.98
| Facility | | $3,391.78 | $7,235.53 | $15,460.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,000.00 / $7,235.53 / $15,232.80
| Facility | | $3,000.00 | $7,235.53 | $15,232.80 |