- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.18 / $11,293.10 / $15,989.80
| Facility | | $6,165.18 | $11,293.10 | $15,989.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,634.64 / $10,679.54 / $16,965.59
| Facility | | $6,634.64 | $10,679.54 | $16,965.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.92 / $10,158.75 / $18,074.03
| Facility | | $6,409.92 | $10,158.75 | $18,074.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,758.88 / $9,473.66 / $21,372.58
| Facility | | $4,758.88 | $9,473.66 | $21,372.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,758.88 / $10,151.90 / $21,372.58
| Facility | | $4,758.88 | $10,151.90 | $21,372.58 |