- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,000.83 / $6,861.40 / $11,047.70
| Facility | | $3,000.83 | $6,861.40 | $11,047.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,209.27 / $2,791.51 / $10,316.95
| Facility | | $1,209.27 | $2,791.51 | $10,316.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,966.77 / $7,174.04 / $10,162.89
| Facility | | $4,966.77 | $7,174.04 | $10,162.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,341.51 / $6,017.06 / $12,636.58
| Facility | | $4,341.51 | $6,017.06 | $12,636.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,076.22 / $6,017.06 / $12,799.74
| Facility | | $4,076.22 | $6,017.06 | $12,799.74 |