- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,117.60 / $8,921.50 / $14,482.40
| Facility | | $6,117.60 | $8,921.50 | $14,482.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,457.62 / $21,975.32 / $28,173.49
| Facility | | $15,457.62 | $21,975.32 | $28,173.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,183.50 / $13,888.62 / $17,566.59
| Facility | | $7,183.50 | $13,888.62 | $17,566.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,382.70 / $9,594.44 / $15,341.90
| Facility | | $6,382.70 | $9,594.44 | $15,341.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,464.49 / $12,764.37 / $19,392.79
| Facility | | $7,464.49 | $12,764.37 | $19,392.79 |