- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,691.99 / $8,441.75 / $13,592.30
| Facility | | $3,691.99 | $8,441.75 | $13,592.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,985.93 / $4,985.93 / $4,985.93
| Facility | | $4,985.93 | $4,985.93 | $4,985.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,161.26 / $11,734.93
| Facility | | $1,474.01 | $5,161.26 | $11,734.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,110.74 / $9,182.26 / $13,910.11
| Facility | | $6,110.74 | $9,182.26 | $13,910.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.46 / $7,402.94 / $15,547.09
| Facility | | $5,341.46 | $7,402.94 | $15,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,015.08 / $7,402.94 / $15,747.83
| Facility | | $5,015.08 | $7,402.94 | $15,747.83 |