- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,969.20 / $9,075.57 / $14,612.80
| Facility | | $3,969.20 | $9,075.57 | $14,612.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,746.46 / $13,023.62
| Facility | | $1,474.01 | $5,746.46 | $13,023.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,569.55 / $9,489.10 / $13,442.44
| Facility | | $6,569.55 | $9,489.10 | $13,442.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,742.51 / $7,958.77 / $16,714.39
| Facility | | $5,742.51 | $7,958.77 | $16,714.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,391.62 / $8,467.70 / $16,930.21
| Facility | | $5,391.62 | $8,467.70 | $16,930.21 |