- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,318.20 / $6,297.38 / $10,222.60
| Facility | | $4,318.20 | $6,297.38 | $10,222.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,377.07 / $14,752.55 / $18,913.53
| Facility | | $10,377.07 | $14,752.55 | $18,913.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,070.58 / $9,803.49 / $12,399.65
| Facility | | $5,070.58 | $9,803.49 | $12,399.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,505.32 / $6,772.38 / $10,829.30
| Facility | | $4,505.32 | $6,772.38 | $10,829.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,268.92 / $9,009.92 / $13,688.69
| Facility | | $5,268.92 | $9,009.92 | $13,688.69 |