- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $7,079.46 / $10,964.78
| Facility | | $5,248.07 | $7,079.46 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $6,456.54 / $10,232.93
| Facility | | $4,073.80 | $6,456.54 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $6,309.57 / $11,220.18
| Facility | | $4,466.84 | $6,309.57 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.98 / $74.13 / $117.49
| Facility | | $48.98 | $74.13 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $7,079.46 / $10,232.93
| Facility | | $4,897.79 | $7,079.46 | $10,232.93 |