- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,149.50 / $7,673.12 / $12,283.50
| Facility | | $5,149.50 | $7,673.12 | $12,283.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,233.54 / $5,233.54 / $6,243.35
| Facility | | $5,233.54 | $5,233.54 | $6,243.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,122.87 / $6,075.01 / $8,621.12
| Facility | | $3,122.87 | $6,075.01 | $8,621.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,568.97 / $6,121.09 / $10,724.96
| Facility | | $4,568.97 | $6,121.09 | $10,724.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,486.37 / $6,932.19 / $9,289.34
| Facility | | $4,486.37 | $6,932.19 | $9,289.34 |