- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $3,715.35 / $10,232.93
| Facility | | $1,380.38 | $3,715.35 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $8,511.38 / $13,803.84
| Facility | | $4,365.16 | $8,511.38 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $14,791.08 / $23,442.29
| Facility | | $9,332.54 | $14,791.08 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $7,585.78 / $7,585.78
| Facility | | $7,585.78 | $7,585.78 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $8,317.64 / $17,378.01
| Facility | | $4,365.16 | $8,317.64 | $17,378.01 |