- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,435.21 / $6,199.38 / $10,063.50
| Facility | | $4,435.21 | $6,199.38 | $10,063.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,738.57 / $11,738.57 / $11,738.57
| Facility | | $11,738.57 | $11,738.57 | $11,738.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,923.86 / $12,686.59 / $16,264.86
| Facility | | $8,923.86 | $12,686.59 | $16,264.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,991.67 / $9,650.93 / $12,206.68
| Facility | | $4,991.67 | $9,650.93 | $12,206.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,435.21 / $6,666.99 / $10,660.80
| Facility | | $4,435.21 | $6,666.99 | $10,660.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,186.93 / $8,869.70 / $13,475.67
| Facility | | $5,186.93 | $8,869.70 | $13,475.67 |