- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,254.39 / $6,332.07 / $13,249.90
| Facility | | $6,254.39 | $6,332.07 | $13,249.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,363.20 / $11,502.27 / $15,433.56
| Facility | | $8,363.20 | $11,502.27 | $15,433.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,852.18 / $9,409.86 / $13,191.08
| Facility | | $6,852.18 | $9,409.86 | $13,191.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,965.44 / $10,450.70 / $13,174.92
| Facility | | $5,965.44 | $10,450.70 | $13,174.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,965.44 / $10,537.70 / $13,818.07
| Facility | | $5,965.44 | $10,537.70 | $13,818.07 |