- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,211.39 / $6,141.63 / $9,969.79
| Facility | | $4,211.39 | $6,141.63 | $9,969.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,636.66 / $13,699.95 / $17,564.04
| Facility | | $9,636.66 | $13,699.95 | $17,564.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,945.17 / $9,561.03 / $12,092.97
| Facility | | $4,945.17 | $9,561.03 | $12,092.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,393.89 / $6,604.88 / $10,561.50
| Facility | | $4,393.89 | $6,604.88 | $10,561.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,138.60 / $8,787.09 / $13,350.14
| Facility | | $5,138.60 | $8,787.09 | $13,350.14 |