- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,924.56 / $6,687.01 / $10,766.90
| Facility | | $2,924.56 | $6,687.01 | $10,766.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,081.46 / $10,011.64
| Facility | | $1,474.01 | $5,081.46 | $10,011.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,840.54 / $6,991.70 / $9,904.58
| Facility | | $4,840.54 | $6,991.70 | $9,904.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,231.16 / $5,864.13 / $12,315.40
| Facility | | $4,231.16 | $5,864.13 | $12,315.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,972.62 / $5,864.13 / $12,474.42
| Facility | | $3,972.62 | $5,864.13 | $12,474.42 |