- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,509.40 / $9,492.87 / $15,409.90
| Facility | | $6,509.40 | $9,492.87 | $15,409.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,553.42 / $22,111.51 / $28,348.09
| Facility | | $15,553.42 | $22,111.51 | $28,348.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,643.57 / $14,778.12 / $18,691.64
| Facility | | $7,643.57 | $14,778.12 | $18,691.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,791.47 / $10,208.90 / $16,324.50
| Facility | | $6,791.47 | $10,208.90 | $16,324.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,942.55 / $13,581.86 / $20,634.80
| Facility | | $7,942.55 | $13,581.86 | $20,634.80 |