- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $7,244.36 / $8,709.64
| Facility | | $5,888.44 | $7,244.36 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $8,912.51 / $10,471.29
| Facility | | $8,912.51 | $8,912.51 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $7,244.36 / $11,481.54
| Facility | | $5,623.41 | $7,244.36 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $9,120.11 / $9,120.11
| Facility | | $4,677.35 | $9,120.11 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $8,128.31 / $12,302.69
| Facility | | $5,888.44 | $8,128.31 | $12,302.69 |