- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,091.80 / $8,883.87 / $14,421.30
| Facility | | $6,091.80 | $8,883.87 | $14,421.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,522.17 / $19,223.79 / $24,645.88
| Facility | | $13,522.17 | $19,223.79 | $24,645.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,153.20 / $13,830.05 / $17,492.50
| Facility | | $7,153.20 | $13,830.05 | $17,492.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,355.78 / $9,553.96 / $15,277.20
| Facility | | $6,355.78 | $9,553.96 | $15,277.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,433.01 / $12,710.54 / $19,311.00
| Facility | | $7,433.01 | $12,710.54 | $19,311.00 |