- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $12,882.50 / $16,595.87
| Facility | | $6,606.93 | $12,882.50 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $9,772.37 / $15,848.93
| Facility | | $6,606.93 | $9,772.37 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $13,182.57 / $17,782.79
| Facility | | $6,309.57 | $13,182.57 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $9,549.93 / $19,498.45
| Facility | | $4,677.35 | $9,549.93 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $9,332.54 / $18,620.87
| Facility | | $4,073.80 | $9,332.54 | $18,620.87 |