- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $10,715.19 / $13,803.84
| Facility | | $7,585.78 | $10,715.19 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $9,332.54 / $12,882.50
| Facility | | $6,456.54 | $9,332.54 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $11,220.18 / $15,488.17
| Facility | | $5,888.44 | $11,220.18 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $12,882.50 / $14,454.40
| Facility | | $6,606.93 | $12,882.50 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $11,220.18 / $15,488.17
| Facility | | $5,888.44 | $11,220.18 | $15,488.17 |