- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,580.58 / $4,764.89 / $9,703.92
| Facility | | $4,580.58 | $4,764.89 | $9,703.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,125.03 / $8,424.01 / $11,303.21
| Facility | | $6,125.03 | $8,424.01 | $11,303.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,018.39 / $6,891.58 / $9,660.86
| Facility | | $5,018.39 | $6,891.58 | $9,660.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,368.96 / $7,653.87 / $9,649.03
| Facility | | $4,368.96 | $7,653.87 | $9,649.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,368.96 / $7,717.59 / $10,120.06
| Facility | | $4,368.96 | $7,717.59 | $10,120.06 |