- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,313.14 / $6,338.80 / $9,786.56
| Facility | | $4,313.14 | $6,338.80 | $9,786.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,350.29 / $9,027.87 / $11,574.21
| Facility | | $6,350.29 | $9,027.87 | $11,574.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,854.29 / $9,385.31 / $11,870.72
| Facility | | $4,854.29 | $9,385.31 | $11,870.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,313.14 / $6,483.49 / $10,367.40
| Facility | | $4,313.14 | $6,483.49 | $10,367.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,044.17 / $8,625.59 / $13,104.78
| Facility | | $5,044.17 | $8,625.59 | $13,104.78 |