- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $7,244.36 / $9,332.54
| Facility | | $6,309.57 | $7,244.36 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $6,165.95 / $11,748.98
| Facility | | $3,162.28 | $6,165.95 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $7,585.78 / $12,589.25
| Facility | | $3,235.94 | $7,585.78 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $8,709.64 / $12,589.25
| Facility | | $6,760.83 | $8,709.64 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $8,317.64 / $13,489.63
| Facility | | $4,168.69 | $8,317.64 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $8,128.31 / $11,481.54
| Facility | | $5,370.32 | $8,128.31 | $11,481.54 |