- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $5,248.07 / $7,585.78
| Facility | | $3,311.31 | $5,248.07 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $8,128.31 / $8,128.31
| Facility | | $8,128.31 | $8,128.31 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $4,677.35 / $7,943.28
| Facility | | $3,715.35 | $4,677.35 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $5,370.32 / $8,511.38
| Facility | | $3,388.44 | $5,370.32 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $4,265.80 / $8,317.64
| Facility | | $2,187.76 | $4,265.80 | $8,317.64 |