- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,483.41 / $6,266.75 / $10,172.90
| Facility | | $4,483.41 | $6,266.75 | $10,172.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,940.09 / $12,709.68 / $16,294.46
| Facility | | $8,940.09 | $12,709.68 | $16,294.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,045.92 / $9,755.82 / $12,339.35
| Facility | | $5,045.92 | $9,755.82 | $12,339.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,483.41 / $6,739.44 / $10,776.70
| Facility | | $4,483.41 | $6,739.44 | $10,776.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,243.30 / $8,966.11 / $13,622.12
| Facility | | $5,243.30 | $8,966.11 | $13,622.12 |