- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,646.60 / $8,234.62 / $13,367.40
| Facility | | $5,646.60 | $8,234.62 | $13,367.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,390.06 / $14,771.02 / $18,937.20
| Facility | | $10,390.06 | $14,771.02 | $18,937.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,630.44 / $12,819.33 / $16,214.13
| Facility | | $6,630.44 | $12,819.33 | $16,214.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,891.29 / $8,855.75 / $14,160.70
| Facility | | $5,891.29 | $8,855.75 | $14,160.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,889.79 / $11,781.63 / $17,899.72
| Facility | | $6,889.79 | $11,781.63 | $17,899.72 |