- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,041.26 / $9,240.34 / $14,878.10
| Facility | | $4,041.26 | $9,240.34 | $14,878.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,679.21 / $12,911.62
| Facility | | $1,474.01 | $5,679.21 | $12,911.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,688.82 / $9,661.37 / $13,686.50
| Facility | | $6,688.82 | $9,661.37 | $13,686.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,846.76 / $8,103.26 / $17,017.84
| Facility | | $5,846.76 | $8,103.26 | $17,017.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,489.50 / $8,103.26 / $17,237.58
| Facility | | $5,489.50 | $8,103.26 | $17,237.58 |