- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,510.26 / $8,353.76 / $13,869.20
| Facility | | $6,510.26 | $8,353.76 | $13,869.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,124.82 / $7,457.15 / $12,603.69
| Facility | | $5,124.82 | $7,457.15 | $12,603.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,200.67 / $8,917.00 / $13,153.00
| Facility | | $7,200.67 | $8,917.00 | $13,153.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,476.25 / $8,945.34 / $21,782.44
| Facility | | $4,476.25 | $8,945.34 | $21,782.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,476.25 / $8,754.83 / $12,003.51
| Facility | | $4,476.25 | $8,754.83 | $12,003.51 |