- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,308.83 / $9,724.50 / $13,768.80
| Facility | | $5,308.83 | $9,724.50 | $13,768.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,200.98 / $9,200.98 / $9,200.98
| Facility | | $9,200.98 | $9,200.98 | $9,200.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,577.10 / $8,854.29 / $14,032.88
| Facility | | $5,577.10 | $8,854.29 | $14,032.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,519.58 / $8,747.70 / $15,563.54
| Facility | | $5,519.58 | $8,747.70 | $15,563.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,097.87 / $8,331.95 / $18,403.91
| Facility | | $4,097.87 | $8,331.95 | $18,403.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,097.87 / $8,741.79 / $18,403.91
| Facility | | $4,097.87 | $8,741.79 | $18,403.91 |