- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,519.72 / $6,642.40 / $10,255.29
| Facility | | $4,519.72 | $6,642.40 | $10,255.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,696.54 / $12,363.43 / $15,850.55
| Facility | | $8,696.54 | $12,363.43 | $15,850.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $278.88 / $9,474.81 / $12,439.27
| Facility | | $278.88 | $9,474.81 | $12,439.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,519.72 / $6,794.02 / $10,863.90
| Facility | | $4,519.72 | $6,794.02 | $10,863.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,948.56 / $9,038.71 / $13,732.44
| Facility | | $5,948.56 | $9,038.71 | $13,732.44 |