- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $9,332.54 / $12,022.64
| Facility | | $6,309.57 | $9,332.54 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $3,981.07 / $8,511.38
| Facility | | $2,041.74 | $3,981.07 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,570.88 / $8,511.38
| Facility | | $3,311.31 | $4,570.88 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,570.88 / $8,511.38
| Facility | | $3,311.31 | $4,570.88 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $5,888.44 / $9,332.54
| Facility | | $3,019.95 | $5,888.44 | $9,332.54 |