- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $12,589.25 / $16,218.10
| Facility | | $8,511.38 | $12,589.25 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $5,370.32 / $11,481.54
| Facility | | $2,884.03 | $5,370.32 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $6,165.95 / $11,220.18
| Facility | | $4,466.84 | $6,165.95 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $6,165.95 / $11,220.18
| Facility | | $4,466.84 | $6,165.95 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $7,762.47 / $12,589.25
| Facility | | $3,311.31 | $7,762.47 | $12,589.25 |