- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $13,803.84 / $18,620.87
| Facility | | $7,244.36 | $13,803.84 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $8,511.38 / $13,803.84
| Facility | | $5,754.40 | $8,511.38 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $7,079.46 / $7,079.46
| Facility | | $7,079.46 | $7,079.46 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $10,715.19 / $23,442.29
| Facility | | $4,466.84 | $10,715.19 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $10,715.19 / $20,892.96
| Facility | | $4,466.84 | $10,715.19 | $20,892.96 |