- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,946.24 / $11,603.90 / $15,251.50
| Facility | | $7,946.24 | $11,603.90 | $15,251.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,649.22 / $12,661.59 / $21,415.37
| Facility | | $4,649.22 | $12,661.59 | $21,415.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,072.29 / $11,655.44 / $19,508.57
| Facility | | $8,072.29 | $11,655.44 | $19,508.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,995.29 / $13,007.62 / $18,992.18
| Facility | | $9,995.29 | $13,007.62 | $18,992.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,995.29 / $12,092.32 / $18,992.18
| Facility | | $9,995.29 | $12,092.32 | $18,992.18 |