- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,171.04 / $6,129.96 / $9,464.12
| Facility | | $4,171.04 | $6,129.96 | $9,464.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,742.31 / $6,742.31 / $14,487.06
| Facility | | $6,742.31 | $6,742.31 | $14,487.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,477.14 / $10,629.87 / $13,628.04
| Facility | | $7,477.14 | $10,629.87 | $13,628.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,694.35 / $9,076.10 / $11,479.62
| Facility | | $4,694.35 | $9,076.10 | $11,479.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,171.04 / $6,269.88 / $10,025.79
| Facility | | $4,171.04 | $6,269.88 | $10,025.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,877.97 / $8,341.41 / $12,673.03
| Facility | | $4,877.97 | $8,341.41 | $12,673.03 |