- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,414.20 / $10,812.40 / $17,551.90
| Facility | | $7,414.20 | $10,812.40 | $17,551.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,806.72 / $22,471.61 / $28,809.76
| Facility | | $15,806.72 | $22,471.61 | $28,809.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,706.01 / $16,832.25 / $21,289.76
| Facility | | $8,706.01 | $16,832.25 | $21,289.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,735.48 / $11,627.90 / $18,593.59
| Facility | | $7,735.48 | $11,627.90 | $18,593.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,046.56 / $15,469.73 / $23,503.01
| Facility | | $9,046.56 | $15,469.73 | $23,503.01 |