- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,186.39 / $7,563.50 / $12,277.90
| Facility | | $5,186.39 | $7,563.50 | $12,277.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,817.29 / $16,800.04 / $21,538.51
| Facility | | $11,817.29 | $16,800.04 | $21,538.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,090.05 / $11,774.55 / $14,892.67
| Facility | | $6,090.05 | $11,774.55 | $14,892.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,411.14 / $8,134.00 / $13,006.60
| Facility | | $5,411.14 | $8,134.00 | $13,006.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,328.27 / $10,821.42 / $16,440.89
| Facility | | $6,328.27 | $10,821.42 | $16,440.89 |