- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $12,589.25 / $28,840.32
| Facility | | $8,709.64 | $12,589.25 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $6,456.54 / $14,125.38
| Facility | | $6,456.54 | $6,456.54 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $9,332.54 / $15,488.17
| Facility | | $5,128.61 | $9,332.54 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $12,589.25 / $17,782.79
| Facility | | $7,943.28 | $12,589.25 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $18,620.87 / $29,512.09
| Facility | | $6,918.31 | $18,620.87 | $29,512.09 |