- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,967.49 / $10,154.70 / $16,859.20
| Facility | | $6,967.49 | $10,154.70 | $16,859.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,126.65 / $9,378.94 / $15,547.88
| Facility | | $6,126.65 | $9,378.94 | $15,547.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,753.01 / $11,100.15 / $17,327.00
| Facility | | $8,753.01 | $11,100.15 | $17,327.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,441.25 / $10,404.54 / $27,395.99
| Facility | | $5,441.25 | $10,404.54 | $27,395.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,441.25 / $10,381.91 / $14,591.26
| Facility | | $5,441.25 | $10,381.91 | $14,591.26 |