- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,258.77 / $8,831.16 / $11,530.30
| Facility | | $4,258.77 | $8,831.16 | $11,530.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,734.59 / $8,064.66 / $21,595.58
| Facility | | $5,734.59 | $8,064.66 | $21,595.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,989.89 / $8,250.91 / $12,467.22
| Facility | | $4,989.89 | $8,250.91 | $12,467.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,717.14 / $11,717.14 / $11,717.14
| Facility | | $11,717.14 | $11,717.14 | $11,717.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,189.47 / $8,312.04 / $12,835.75
| Facility | | $7,189.47 | $8,312.04 | $12,835.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,734.59 / $8,064.66 / $21,595.58
| Facility | | $5,734.59 | $8,064.66 | $21,595.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,734.59 / $7,960.50 / $16,877.14
| Facility | | $5,734.59 | $7,960.50 | $16,877.14 |