- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,632.14 / $8,484.95 / $12,013.80
| Facility | | $4,632.14 | $8,484.95 | $12,013.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,321.47 / $8,608.18 / $14,234.23
| Facility | | $5,321.47 | $8,608.18 | $14,234.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,816.02 / $7,632.66 / $13,579.72
| Facility | | $4,816.02 | $7,632.66 | $13,579.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,575.53 / $7,404.27 / $16,058.04
| Facility | | $3,575.53 | $7,404.27 | $16,058.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,064.74 / $7,440.75 / $14,270.01
| Facility | | $3,064.74 | $7,440.75 | $14,270.01 |