- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,545.80 / $8,087.63 / $13,128.80
| Facility | | $5,545.80 | $8,087.63 | $13,128.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,847.37 / $14,043.84 / $18,031.62
| Facility | | $9,847.37 | $14,043.84 | $18,031.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,512.07 / $12,590.48 / $15,924.68
| Facility | | $6,512.07 | $12,590.48 | $15,924.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,786.12 / $8,697.66 / $13,907.90
| Facility | | $5,786.12 | $8,697.66 | $13,907.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,766.80 / $11,571.31 / $17,580.18
| Facility | | $6,766.80 | $11,571.31 | $17,580.18 |