- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,332.26 / $9,609.74 / $15,383.80
| Facility | | $6,332.26 | $9,609.74 | $15,383.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,598.52 / $9,598.52 / $9,598.52
| Facility | | $9,598.52 | $9,598.52 | $9,598.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,825.40 / $7,441.67 / $10,560.57
| Facility | | $3,825.40 | $7,441.67 | $10,560.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,722.14 / $7,665.99 / $13,431.83
| Facility | | $5,722.14 | $7,665.99 | $13,431.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,618.68 / $8,681.81 / $11,633.88
| Facility | | $5,618.68 | $8,681.81 | $11,633.88 |