- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,338.60 / $6,327.13 / $10,270.90
| Facility | | $4,338.60 | $6,327.13 | $10,270.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.69 / $7,713.06 / $12,756.50
| Facility | | $6,918.69 | $7,713.06 | $12,756.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,094.74 / $15,772.83 / $20,221.58
| Facility | | $11,094.74 | $15,772.83 | $20,221.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,094.54 / $9,849.81 / $12,458.22
| Facility | | $5,094.54 | $9,849.81 | $12,458.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,526.60 / $6,804.37 / $10,880.50
| Facility | | $4,526.60 | $6,804.37 | $10,880.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,957.62 / $9,052.49 / $13,753.36
| Facility | | $5,957.62 | $9,052.49 | $13,753.36 |