- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $8,317.64 / $11,220.18
| Facility | | $3,235.94 | $8,317.64 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $6,456.54 / $6,456.54
| Facility | | $6,456.54 | $6,456.54 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $8,317.64 / $9,549.93
| Facility | | $6,165.95 | $8,317.64 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $8,709.64 / $12,302.69
| Facility | | $7,079.46 | $8,709.64 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $6,025.60 / $10,715.19
| Facility | | $1,819.70 | $6,025.60 | $10,715.19 |