- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,698.83 / $9,363.37 / $15,199.70
| Facility | | $6,698.83 | $9,363.37 | $15,199.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,539.23 / $12,350.66 / $15,658.99
| Facility | | $10,539.23 | $12,350.66 | $15,658.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,851.96 / $21,202.25 / $27,196.89
| Facility | | $14,851.96 | $21,202.25 | $27,196.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,539.29 / $14,576.52 / $18,436.66
| Facility | | $7,539.29 | $14,576.52 | $18,436.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,698.83 / $10,069.60 / $16,101.80
| Facility | | $6,698.83 | $10,069.60 | $16,101.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,263.84 / $13,396.58 / $20,353.30
| Facility | | $7,263.84 | $13,396.58 | $20,353.30 |