- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $11,220.18 / $14,454.40
| Facility | | $7,585.78 | $11,220.18 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $4,786.30 / $10,232.93
| Facility | | $2,454.71 | $4,786.30 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $5,495.41 / $10,232.93
| Facility | | $3,981.07 | $5,495.41 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $5,495.41 / $10,232.93
| Facility | | $3,981.07 | $5,495.41 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $7,079.46 / $11,220.18
| Facility | | $3,019.95 | $7,079.46 | $11,220.18 |