- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $5,888.44 / $6,606.93
| Facility | | $4,466.84 | $5,888.44 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $7,413.10 / $7,413.10
| Facility | | $6,456.54 | $7,413.10 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $5,248.07 / $6,309.57
| Facility | | $4,466.84 | $5,248.07 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $6,606.93 / $8,317.64
| Facility | | $4,073.80 | $6,606.93 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $8,511.38 / $8,511.38
| Facility | | $7,413.10 | $8,511.38 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $6,165.95 / $7,943.28
| Facility | | $1,513.56 | $6,165.95 | $7,943.28 |