- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,530.60 / $6,607.13 / $10,725.40
| Facility | | $4,530.60 | $6,607.13 | $10,725.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,878.46 / $8,743.12 / $10,377.68
| Facility | | $6,878.46 | $8,743.12 | $10,377.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,404.46 / $13,369.86 / $17,140.84
| Facility | | $9,404.46 | $13,369.86 | $17,140.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,319.99 / $10,285.70 / $13,009.55
| Facility | | $5,319.99 | $10,285.70 | $13,009.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,726.93 / $7,105.49 / $11,362.00
| Facility | | $4,726.93 | $7,105.49 | $11,362.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,528.09 / $9,453.10 / $14,362.00
| Facility | | $5,528.09 | $9,453.10 | $14,362.00 |