- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $8,912.51 / $15,488.17
| Facility | | $6,456.54 | $8,912.51 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $7,943.28 / $12,589.25
| Facility | | $5,011.87 | $7,943.28 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $7,762.47 / $13,803.84
| Facility | | $5,495.41 | $7,762.47 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.66 / $91.20 / $138.04
| Facility | | $61.66 | $91.20 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $8,709.64 / $12,589.25
| Facility | | $5,888.44 | $8,709.64 | $12,589.25 |