- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,578.20 / $8,134.88 / $13,205.50
| Facility | | $5,578.20 | $8,134.88 | $13,205.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,350.06 / $18,979.11 / $24,332.19
| Facility | | $13,350.06 | $18,979.11 | $24,332.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,550.12 / $12,664.04 / $16,017.72
| Facility | | $6,550.12 | $12,664.04 | $16,017.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,819.92 / $8,748.48 / $13,989.20
| Facility | | $5,819.92 | $8,748.48 | $13,989.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,550.16 / $11,638.91 / $17,682.89
| Facility | | $7,550.16 | $11,638.91 | $17,682.89 |