- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,795.62 / $8,678.68 / $13,973.80
| Facility | | $3,795.62 | $8,678.68 | $13,973.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,799.85 / $7,549.68 / $8,008.59
| Facility | | $6,799.85 | $7,549.68 | $8,008.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,750.90 / $12,517.94
| Facility | | $1,474.01 | $5,750.90 | $12,517.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,282.25 / $9,074.12 / $12,854.58
| Facility | | $6,282.25 | $9,074.12 | $12,854.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,491.38 / $7,610.72 / $15,983.44
| Facility | | $5,491.38 | $7,610.72 | $15,983.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,155.83 / $7,610.72 / $16,189.82
| Facility | | $5,155.83 | $7,610.72 | $16,189.82 |