- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,329.47 / $8,401.58 / $13,948.60
| Facility | | $5,329.47 | $8,401.58 | $13,948.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,670.28 / $7,149.46 / $12,083.64
| Facility | | $4,670.28 | $7,149.46 | $12,083.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,562.65 / $8,557.16 / $12,885.19
| Facility | | $6,562.65 | $8,557.16 | $12,885.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,501.88 / $8,996.54 / $20,883.65
| Facility | | $4,501.88 | $8,996.54 | $20,883.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,501.88 / $8,804.95 / $12,072.23
| Facility | | $4,501.88 | $8,804.95 | $12,072.23 |