- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $6,760.83 / $10,964.78
| Facility | | $4,897.79 | $6,760.83 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $6,165.95 / $9,549.93
| Facility | | $3,801.89 | $6,165.95 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $5,888.44 / $10,471.29
| Facility | | $4,168.69 | $5,888.44 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.77 / $69.18 / $112.20
| Facility | | $46.77 | $69.18 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $6,606.93 / $9,549.93
| Facility | | $4,570.88 | $6,606.93 | $9,549.93 |