- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,269.95 / $5,968.38 / $9,688.54
| Facility | | $4,269.95 | $5,968.38 | $9,688.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,657.37 / $10,886.09 / $13,956.53
| Facility | | $7,657.37 | $10,886.09 | $13,956.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,805.67 / $9,291.32 / $11,751.84
| Facility | | $4,805.67 | $9,291.32 | $11,751.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,269.95 / $6,418.56 / $10,263.60
| Facility | | $4,269.95 | $6,418.56 | $10,263.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,993.64 / $8,539.20 / $12,973.54
| Facility | | $4,993.64 | $8,539.20 | $12,973.54 |