- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,809.56 / $7,068.36 / $10,912.90
| Facility | | $4,809.56 | $7,068.36 | $10,912.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,383.45 / $9,383.45 / $11,189.92
| Facility | | $9,383.45 | $9,383.45 | $11,189.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,853.64 / $9,743.46 / $12,491.63
| Facility | | $6,853.64 | $9,743.46 | $12,491.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,412.99 / $10,465.51 / $13,236.97
| Facility | | $5,412.99 | $10,465.51 | $13,236.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,809.56 / $7,229.70 / $11,560.60
| Facility | | $4,809.56 | $7,229.70 | $11,560.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,624.72 / $9,618.35 / $14,613.07
| Facility | | $5,624.72 | $9,618.35 | $14,613.07 |