- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,934.60 / $8,654.62 / $14,049.20
| Facility | | $5,934.60 | $8,654.62 | $14,049.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,526.65 / $16,386.84 / $21,008.78
| Facility | | $11,526.65 | $16,386.84 | $21,008.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,968.62 / $13,473.16 / $17,041.11
| Facility | | $6,968.62 | $13,473.16 | $17,041.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,191.77 / $9,307.43 / $14,883.00
| Facility | | $6,191.77 | $9,307.43 | $14,883.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,241.20 / $12,382.54 / $18,812.68
| Facility | | $7,241.20 | $12,382.54 | $18,812.68 |