- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,506.78 / $8,619.14 / $15,080.20
| Facility | | $6,506.78 | $8,619.14 | $15,080.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,991.78 / $9,837.95 / $20,939.06
| Facility | | $6,991.78 | $9,837.95 | $20,939.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,151.00 / $8,992.65 / $14,875.38
| Facility | | $5,151.00 | $8,992.65 | $14,875.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,241.31 / $9,392.16 / $15,334.27
| Facility | | $6,241.31 | $9,392.16 | $15,334.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,300.00 / $9,534.69 / $13,566.82
| Facility | | $3,300.00 | $9,534.69 | $13,566.82 |