- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,697.18 / $13,138.80 / $21,356.10
| Facility | | $7,697.18 | $13,138.80 | $21,356.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,690.32 / $11,231.00 / $13,510.00
| Facility | | $9,690.32 | $11,231.00 | $13,510.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,640.00 / $10,439.42 / $16,469.20
| Facility | | $6,640.00 | $10,439.42 | $16,469.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,978.71 / $10,614.63 / $19,750.43
| Facility | | $5,978.71 | $10,614.63 | $19,750.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,164.00 / $11,055.96 / $15,014.87
| Facility | | $6,164.00 | $11,055.96 | $15,014.87 |