- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,591.60 / $9,612.75 / $15,604.50
| Facility | | $6,591.60 | $9,612.75 | $15,604.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,028.97 / $21,365.92 / $27,392.21
| Facility | | $15,028.97 | $21,365.92 | $27,392.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,740.09 / $14,964.73 / $18,927.68
| Facility | | $7,740.09 | $14,964.73 | $18,927.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,877.24 / $10,337.79 / $16,530.59
| Facility | | $6,877.24 | $10,337.79 | $16,530.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,042.85 / $13,753.37 / $20,895.37
| Facility | | $8,042.85 | $13,753.37 | $20,895.37 |