- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $14,125.38 / $18,197.01
| Facility | | $9,549.93 | $14,125.38 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $6,025.60 / $12,882.50
| Facility | | $3,235.94 | $6,025.60 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $6,918.31 / $12,589.25
| Facility | | $5,011.87 | $6,918.31 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $6,918.31 / $12,589.25
| Facility | | $5,011.87 | $6,918.31 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $8,709.64 / $14,125.38
| Facility | | $3,715.35 | $8,709.64 | $14,125.38 |