- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,518.80 / $8,048.25 / $13,064.80
| Facility | | $5,518.80 | $8,048.25 | $13,064.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,413.19 / $17,647.20 / $22,624.61
| Facility | | $12,413.19 | $17,647.20 | $22,624.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,480.37 / $12,529.18 / $15,847.15
| Facility | | $6,480.37 | $12,529.18 | $15,847.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,757.95 / $8,655.32 / $13,840.20
| Facility | | $5,757.95 | $8,655.32 | $13,840.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,733.86 / $11,514.98 / $17,494.59
| Facility | | $6,733.86 | $11,514.98 | $17,494.59 |