- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,644.80 / $9,703.37 / $12,753.60
| Facility | | $6,644.80 | $9,703.37 | $12,753.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,501.03 / $17,704.75 / $29,945.22
| Facility | | $6,501.03 | $17,704.75 | $29,945.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,064.03 / $9,746.50 / $16,313.44
| Facility | | $7,064.03 | $9,746.50 | $16,313.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,358.25 / $10,877.22 / $15,881.63
| Facility | | $8,358.25 | $10,877.22 | $15,881.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,358.25 / $10,111.83 / $15,881.63
| Facility | | $8,358.25 | $10,111.83 | $15,881.63 |