- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $12,022.64 / $20,892.96
| Facility | | $8,709.64 | $12,022.64 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $10,715.19 / $16,218.10
| Facility | | $6,760.83 | $10,715.19 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $10,471.29 / $18,620.87
| Facility | | $7,413.10 | $10,471.29 | $18,620.87 |
- 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 / $16,982.44
| Facility | | $7,762.47 | $11,481.54 | $16,982.44 |