- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,085.78 / $10,996.30 / $17,603.40
| Facility | | $7,085.78 | $10,996.30 | $17,603.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,406.23 / $10,406.23 / $10,406.23
| Facility | | $10,406.23 | $10,406.23 | $10,406.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,453.17 / $8,662.89 / $12,293.62
| Facility | | $4,453.17 | $8,662.89 | $12,293.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,547.75 / $8,772.06 / $15,369.81
| Facility | | $6,547.75 | $8,772.06 | $15,369.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,429.36 / $9,934.44 / $13,312.45
| Facility | | $6,429.36 | $9,934.44 | $13,312.45 |