- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,741.85 / $11,183.60 / $15,007.50
| Facility | | $6,741.85 | $11,183.60 | $15,007.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,104.44 / $6,104.44 / $9,553.61
| Facility | | $6,104.44 | $6,104.44 | $9,553.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,516.75 / $9,650.37 / $15,174.67
| Facility | | $5,516.75 | $9,650.37 | $15,174.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,535.97 / $9,004.50 / $20,650.91
| Facility | | $5,535.97 | $9,004.50 | $20,650.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,572.68 / $8,837.02 / $12,565.48
| Facility | | $6,572.68 | $8,837.02 | $12,565.48 |