- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,309.38 / $6,333.28 / $9,778.03
| Facility | | $4,309.38 | $6,333.28 | $9,778.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,318.50 / $7,318.50 / $8,169.82
| Facility | | $7,318.50 | $7,318.50 | $8,169.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,747.07 / $13,856.92 / $17,765.28
| Facility | | $9,747.07 | $13,856.92 | $17,765.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,850.06 / $9,377.14 / $11,860.38
| Facility | | $4,850.06 | $9,377.14 | $11,860.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,309.38 / $6,477.84 / $10,358.40
| Facility | | $4,309.38 | $6,477.84 | $10,358.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,671.73 / $8,618.08 / $13,093.37
| Facility | | $5,671.73 | $8,618.08 | $13,093.37 |