- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,606.46 / $7,836.50 / $12,721.10
| Facility | | $5,606.46 | $7,836.50 | $12,721.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,808.14 / $21,051.99 / $26,989.73
| Facility | | $14,808.14 | $21,051.99 | $26,989.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.87 / $12,199.54 / $15,430.21
| Facility | | $6,309.87 | $12,199.54 | $15,430.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,606.46 / $8,427.60 / $13,476.10
| Facility | | $5,606.46 | $8,427.60 | $13,476.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,556.69 / $11,212.02 / $17,034.31
| Facility | | $6,556.69 | $11,212.02 | $17,034.31 |