- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $11,748.98 / $20,892.96
| Facility | | $8,511.38 | $11,748.98 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,715.19 / $15,848.93
| Facility | | $6,606.93 | $10,715.19 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $10,232.93 / $18,197.01
| Facility | | $7,244.36 | $10,232.93 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $117.49 / $181.97
| Facility | | $81.28 | $117.49 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $11,481.54 / $16,595.87
| Facility | | $7,762.47 | $11,481.54 | $16,595.87 |