- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $9,772.37 / $13,182.57
| Facility | | $3,801.89 | $9,772.37 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $10,232.93 / $23,442.29
| Facility | | $9,772.37 | $10,232.93 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $10,964.78 / $12,302.69
| Facility | | $7,943.28 | $10,964.78 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $10,232.93 / $14,125.38
| Facility | | $8,317.64 | $10,232.93 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $6,309.57 / $12,589.25
| Facility | | $1,819.70 | $6,309.57 | $12,589.25 |