- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,630.35 / $8,561.37 / $14,213.90
| Facility | | $5,630.35 | $8,561.37 | $14,213.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,271.89 / $7,897.60 / $13,378.70
| Facility | | $5,271.89 | $7,897.60 | $13,378.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,379.64 / $9,131.69 / $13,130.26
| Facility | | $7,379.64 | $9,131.69 | $13,130.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,587.50 / $9,167.66 / $23,573.80
| Facility | | $4,587.50 | $9,167.66 | $23,573.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,587.50 / $8,972.42 / $12,301.84
| Facility | | $4,587.50 | $8,972.42 | $12,301.84 |