- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,184.80 / $9,019.50 / $14,641.50
| Facility | | $6,184.80 | $9,019.50 | $14,641.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,737.37 / $13,682.81 / $14,979.29
| Facility | | $12,737.37 | $13,682.81 | $14,979.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,372.79 / $19,011.41 / $24,373.62
| Facility | | $13,372.79 | $19,011.41 | $24,373.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,262.41 / $14,041.19 / $17,759.56
| Facility | | $7,262.41 | $14,041.19 | $17,759.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,452.81 / $9,699.83 / $15,510.40
| Facility | | $6,452.81 | $9,699.83 | $15,510.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,546.49 / $12,904.59 / $19,605.82
| Facility | | $7,546.49 | $12,904.59 | $19,605.82 |