- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $7,079.46 / $9,549.93
| Facility | | $2,818.38 | $7,079.46 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $7,943.28 / $17,782.79
| Facility | | $3,548.13 | $7,943.28 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $5,623.41 / $6,456.54
| Facility | | $4,168.69 | $5,623.41 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $7,585.78 / $10,471.29
| Facility | | $6,025.60 | $7,585.78 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $6,025.60 / $9,332.54
| Facility | | $1,819.70 | $6,025.60 | $9,332.54 |