- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $12,882.50 / $16,595.87
| Facility | | $8,709.64 | $12,882.50 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $5,495.41 / $11,748.98
| Facility | | $2,951.21 | $5,495.41 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $6,165.95 / $11,481.54
| Facility | | $4,466.84 | $6,165.95 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $6,165.95 / $11,481.54
| Facility | | $4,466.84 | $6,165.95 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $7,943.28 / $12,589.25
| Facility | | $3,388.44 | $7,943.28 | $12,589.25 |