- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $7,244.36 / $9,772.37
| Facility | | $2,818.38 | $7,244.36 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $7,413.10 / $20,417.38
| Facility | | $4,365.16 | $7,413.10 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $6,918.31 / $7,762.47
| Facility | | $5,011.87 | $6,918.31 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $7,762.47 / $10,715.19
| Facility | | $6,165.95 | $7,762.47 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $6,025.60 / $9,549.93
| Facility | | $1,819.70 | $6,025.60 | $9,549.93 |