- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,999.24 / $6,987.75 / $11,343.30
| Facility | | $4,999.24 | $6,987.75 | $11,343.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,632.59 / $19,380.75 / $24,847.12
| Facility | | $13,632.59 | $19,380.75 | $24,847.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,626.46 / $10,878.24 / $13,759.01
| Facility | | $5,626.46 | $10,878.24 | $13,759.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,999.24 / $7,514.83 / $12,016.50
| Facility | | $4,999.24 | $7,514.83 | $12,016.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,579.67 / $9,997.67 / $15,189.37
| Facility | | $6,579.67 | $9,997.67 | $15,189.37 |