- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $10,715.19 / $16,595.87
| Facility | | $8,511.38 | $10,715.19 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $6,025.60 / $6,025.60
| Facility | | $6,025.60 | $6,025.60 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $11,481.54 / $16,595.87
| Facility | | $5,754.40 | $11,481.54 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $8,511.38 / $15,848.93
| Facility | | $6,165.95 | $8,511.38 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $9,772.37 / $14,791.08
| Facility | | $3,311.31 | $9,772.37 | $14,791.08 |