- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,283.15 / $9,450.35 / $15,128.60
| Facility | | $6,283.15 | $9,450.35 | $15,128.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,121.00 / $6,121.00 / $6,121.00
| Facility | | $6,121.00 | $6,121.00 | $6,121.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,975.49 / $7,733.65 / $10,974.93
| Facility | | $3,975.49 | $7,733.65 | $10,974.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,627.24 / $7,538.84 / $13,209.05
| Facility | | $5,627.24 | $7,538.84 | $13,209.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,525.49 / $8,537.81 / $11,440.92
| Facility | | $5,525.49 | $8,537.81 | $11,440.92 |