- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,262.50 / $13,706.10 / $18,392.50
| Facility | | $8,262.50 | $13,706.10 | $18,392.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,523.60 / $8,988.07 / $12,356.89
| Facility | | $4,523.60 | $8,988.07 | $12,356.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,805.35 / $11,745.99 / $18,469.93
| Facility | | $6,805.35 | $11,745.99 | $18,469.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,784.63 / $11,035.50 / $25,308.82
| Facility | | $6,784.63 | $11,035.50 | $25,308.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,055.18 / $10,870.70 / $15,589.48
| Facility | | $8,055.18 | $10,870.70 | $15,589.48 |