- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $8,317.64 / $10,964.78
| Facility | | $5,128.61 | $8,317.64 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $10,471.29 / $12,882.50
| Facility | | $7,079.46 | $10,471.29 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $9,772.37 / $9,772.37
| Facility | | $9,772.37 | $9,772.37 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $7,943.28 / $10,471.29
| Facility | | $5,248.07 | $7,943.28 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $9,772.37 / $9,772.37
| Facility | | $9,772.37 | $9,772.37 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $7,762.47 / $11,481.54
| Facility | | $4,570.88 | $7,762.47 | $11,481.54 |