- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,234.34 / $7,111.28 / $11,197.20
| Facility | | $5,234.34 | $7,111.28 | $11,197.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,181.80 / $6,644.66 / $10,703.39
| Facility | | $4,181.80 | $6,644.66 | $10,703.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,566.28 / $6,304.03 / $11,410.00
| Facility | | $4,566.28 | $6,304.03 | $11,410.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.46 / $70.40 / $120.00
| Facility | | $48.46 | $70.40 | $120.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,029.53 / $6,960.67 / $11,455.64
| Facility | | $5,029.53 | $6,960.67 | $11,455.64 |