- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,413.74 / $7,805.52 / $12,567.90
| Facility | | $3,413.74 | $7,805.52 | $12,567.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $4,813.96 / $10,987.35
| Facility | | $1,474.01 | $4,813.96 | $10,987.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,650.19 / $8,161.18 / $11,561.29
| Facility | | $5,650.19 | $8,161.18 | $11,561.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,938.89 / $6,845.00 / $14,375.35
| Facility | | $4,938.89 | $6,845.00 | $14,375.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,637.10 / $6,845.00 / $14,560.96
| Facility | | $4,637.10 | $6,845.00 | $14,560.96 |