- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $10,471.29 / $13,489.63
| Facility | | $7,244.36 | $10,471.29 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $8,912.51 / $13,489.63
| Facility | | $5,248.07 | $8,912.51 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $10,471.29 / $16,218.10
| Facility | | $7,244.36 | $10,471.29 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $10,471.29 / $14,454.40
| Facility | | $7,079.46 | $10,471.29 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $7,244.36 / $12,022.64
| Facility | | $4,570.88 | $7,244.36 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $10,471.29 / $15,848.93
| Facility | | $6,025.60 | $10,471.29 | $15,848.93 |