- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $9,120.11 / $12,882.50
| Facility | | $6,025.60 | $9,120.11 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $12,022.64 / $20,417.38
| Facility | | $4,466.84 | $12,022.64 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $7,762.47 / $12,302.69
| Facility | | $5,370.32 | $7,762.47 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $8,317.64 / $12,022.64
| Facility | | $6,606.93 | $8,317.64 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $7,943.28 / $11,748.98
| Facility | | $4,570.88 | $7,943.28 | $11,748.98 |