- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $11,748.98 / $14,791.08
| Facility | | $8,317.64 | $11,748.98 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $10,232.93 / $14,125.38
| Facility | | $6,760.83 | $10,232.93 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $12,302.69 / $16,982.44
| Facility | | $6,456.54 | $12,302.69 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $11,220.18 / $13,489.63
| Facility | | $6,760.83 | $11,220.18 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $12,302.69 / $16,982.44
| Facility | | $6,309.57 | $12,302.69 | $16,982.44 |