- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,567.92 / $6,713.24 / $10,364.70
| Facility | | $4,567.92 | $6,713.24 | $10,364.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,720.27 / $19,505.41 / $25,006.93
| Facility | | $13,720.27 | $19,505.41 | $25,006.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,141.04 / $9,939.70 / $12,571.94
| Facility | | $5,141.04 | $9,939.70 | $12,571.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,567.92 / $6,866.48 / $10,979.80
| Facility | | $4,567.92 | $6,866.48 | $10,979.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,342.13 / $9,135.11 / $13,878.89
| Facility | | $5,342.13 | $9,135.11 | $13,878.89 |