- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,476.53 / $6,578.92 / $10,311.70
| Facility | | $4,476.53 | $6,578.92 | $10,311.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,707.70 / $10,957.65 / $14,048.27
| Facility | | $7,707.70 | $10,957.65 | $14,048.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,038.17 / $9,740.83 / $12,320.39
| Facility | | $5,038.17 | $9,740.83 | $12,320.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,476.53 / $6,729.09 / $10,760.10
| Facility | | $4,476.53 | $6,729.09 | $10,760.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,235.25 / $8,952.34 / $13,601.20
| Facility | | $5,235.25 | $8,952.34 | $13,601.20 |