- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $10,715.19 / $16,595.87
| Facility | | $8,511.38 | $10,715.19 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $8,128.31 / $8,709.64
| Facility | | $6,309.57 | $8,128.31 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $10,715.19 / $15,848.93
| Facility | | $5,623.41 | $10,715.19 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $8,511.38 / $15,848.93
| Facility | | $6,165.95 | $8,511.38 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $8,912.51 / $12,882.50
| Facility | | $3,162.28 | $8,912.51 | $12,882.50 |