- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,794.14 / $7,095.14 / $9,918.87
| Facility | | $4,794.14 | $7,095.14 | $9,918.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,685.87 / $8,659.50 / $10,250.02
| Facility | | $7,685.87 | $8,659.50 | $10,250.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,382.76 / $9,074.04 / $11,633.40
| Facility | | $6,382.76 | $9,074.04 | $11,633.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,099.98 / $6,073.37 / $11,871.73
| Facility | | $3,099.98 | $6,073.37 | $11,871.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,794.14 / $8,365.00 / $10,872.70
| Facility | | $4,794.14 | $8,365.00 | $10,872.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,800.00 / $6,791.00 / $11,349.96
| Facility | | $3,800.00 | $6,791.00 | $11,349.96 |