- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,517.22 / $6,638.72 / $10,249.60
| Facility | | $4,517.22 | $6,638.72 | $10,249.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,406.38 / $10,740.14 / $13,003.62
| Facility | | $7,406.38 | $10,740.14 | $13,003.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,340.55 / $9,014.04 / $11,556.46
| Facility | | $6,340.55 | $9,014.04 | $11,556.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,319.80 / $6,473.72 / $11,361.59
| Facility | | $3,319.80 | $6,473.72 | $11,361.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,517.22 / $6,790.26 / $10,857.90
| Facility | | $4,517.22 | $6,790.26 | $10,857.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,898.22 / $9,033.70 / $13,724.83
| Facility | | $4,898.22 | $9,033.70 | $13,724.83 |