- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,646.20 / $9,692.37 / $15,733.80
| Facility | | $6,646.20 | $9,692.37 | $15,733.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,013.29 / $11,411.99 / $15,339.06
| Facility | | $11,013.29 | $11,411.99 | $15,339.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,088.45 / $17,185.53 / $22,032.73
| Facility | | $12,088.45 | $17,185.53 | $22,032.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,804.20 / $15,088.69 / $19,084.46
| Facility | | $7,804.20 | $15,088.69 | $19,084.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,934.20 / $10,423.50 / $16,667.59
| Facility | | $6,934.20 | $10,423.50 | $16,667.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,109.47 / $13,867.30 / $21,068.45
| Facility | | $8,109.47 | $13,867.30 | $21,068.45 |