- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.66 / $7,850.36 / $12,120.30
| Facility | | $5,341.66 | $7,850.36 | $12,120.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,319.01 / $17,513.32 / $22,452.97
| Facility | | $12,319.01 | $17,513.32 | $22,452.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,011.85 / $11,623.35 / $14,701.43
| Facility | | $6,011.85 | $11,623.35 | $14,701.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.66 / $8,029.55 / $12,839.60
| Facility | | $5,341.66 | $8,029.55 | $12,839.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,247.01 / $10,682.46 / $16,229.77
| Facility | | $6,247.01 | $10,682.46 | $16,229.77 |