- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,423.72 / $7,099.56 / $9,269.48
| Facility | | $3,423.72 | $7,099.56 | $9,269.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,610.16 / $6,574.83 / $17,361.15
| Facility | | $4,610.16 | $6,574.83 | $17,361.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,011.49 / $6,633.08 / $10,022.67
| Facility | | $4,011.49 | $6,633.08 | $10,022.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,419.66 / $9,419.66 / $9,419.66
| Facility | | $9,419.66 | $9,419.66 | $9,419.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,779.77 / $6,682.23 / $10,318.94
| Facility | | $5,779.77 | $6,682.23 | $10,318.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,610.16 / $6,574.83 / $17,361.15
| Facility | | $4,610.16 | $6,574.83 | $17,361.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,610.16 / $6,574.83 / $13,567.90
| Facility | | $4,610.16 | $6,574.83 | $13,567.90 |