- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,504.74 / $8,013.59 / $12,902.90
| Facility | | $3,504.74 | $8,013.59 | $12,902.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,257.02 / $4,257.02 / $7,179.98
| Facility | | $4,257.02 | $4,257.02 | $7,179.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.76 / $4,864.93 / $10,897.93
| Facility | | $1,258.76 | $4,864.93 | $10,897.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,800.81 / $8,378.71 / $11,869.47
| Facility | | $5,800.81 | $8,378.71 | $11,869.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,070.54 / $7,027.47 / $14,758.55
| Facility | | $5,070.54 | $7,027.47 | $14,758.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,760.71 / $7,027.47 / $14,949.11
| Facility | | $4,760.71 | $7,027.47 | $14,949.11 |