- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,899.92 / $9,531.17 / $13,188.70
| Facility | | $5,899.92 | $9,531.17 | $13,188.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,314.96 / $9,314.96 / $9,314.96
| Facility | | $9,314.96 | $9,314.96 | $9,314.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,649.50 / $8,773.46 / $13,292.00
| Facility | | $5,649.50 | $8,773.46 | $13,292.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,692.92 / $8,305.94 / $13,651.15
| Facility | | $5,692.92 | $8,305.94 | $13,651.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,266.15 / $7,974.05 / $12,118.27
| Facility | | $6,266.15 | $7,974.05 | $12,118.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,385.60 / $10,426.52 / $14,977.35
| Facility | | $5,385.60 | $10,426.52 | $14,977.35 |