- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,620.98 / $8,279.39 / $13,330.90
| Facility | | $3,620.98 | $8,279.39 | $13,330.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,487.21 / $3,487.21 / $3,487.21
| Facility | | $3,487.21 | $3,487.21 | $3,487.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,156.82 / $11,840.88
| Facility | | $1,474.01 | $5,156.82 | $11,840.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,993.21 / $8,656.62 / $12,263.16
| Facility | | $5,993.21 | $8,656.62 | $12,263.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,238.72 / $7,260.55 / $15,248.06
| Facility | | $5,238.72 | $7,260.55 | $15,248.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,918.62 / $7,519.39 / $13,089.93
| Facility | | $4,918.62 | $7,519.39 | $13,089.93 |