- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,594.84 / $6,422.50 / $10,425.70
| Facility | | $4,594.84 | $6,422.50 | $10,425.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,333.23 / $14,690.22 / $18,833.62
| Facility | | $10,333.23 | $14,690.22 | $18,833.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,171.33 / $9,998.28 / $12,646.02
| Facility | | $5,171.33 | $9,998.28 | $12,646.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,594.84 / $6,906.94 / $11,044.50
| Facility | | $4,594.84 | $6,906.94 | $11,044.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,373.61 / $9,188.95 / $13,960.68
| Facility | | $5,373.61 | $9,188.95 | $13,960.68 |