- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,443.72 / $7,874.08 / $12,678.30
| Facility | | $3,443.72 | $7,874.08 | $12,678.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,002.92 / $12,002.92 / $12,002.92
| Facility | | $12,002.92 | $12,002.92 | $12,002.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,017.71 / $12,161.60
| Facility | | $1,474.01 | $5,017.71 | $12,161.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,699.82 / $8,232.85 / $11,662.83
| Facility | | $5,699.82 | $8,232.85 | $11,662.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,982.27 / $6,905.12 / $14,501.61
| Facility | | $4,982.27 | $6,905.12 | $14,501.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.83 / $6,905.12 / $14,688.85
| Facility | | $4,677.83 | $6,905.12 | $14,688.85 |