- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $7,943.28 / $9,549.93
| Facility | | $6,606.93 | $7,943.28 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $7,079.46 / $11,481.54
| Facility | | $7,079.46 | $7,079.46 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $8,128.31 / $12,589.25
| Facility | | $6,309.57 | $8,128.31 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $10,715.19 / $10,715.19
| Facility | | $5,128.61 | $10,715.19 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $9,120.11 / $13,489.63
| Facility | | $6,606.93 | $9,120.11 | $13,489.63 |