- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,388.05 / $10,326.79 / $16,763.59
| Facility | | $7,388.05 | $10,326.79 | $16,763.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,848.54 / $19,687.75 / $25,240.72
| Facility | | $13,848.54 | $19,687.75 | $25,240.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,314.99 / $16,214.53 / $23,553.25
| Facility | | $8,314.99 | $16,214.53 | $23,553.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,388.05 / $11,105.70 / $17,758.50
| Facility | | $7,388.05 | $11,105.70 | $17,758.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,640.24 / $14,774.92 / $22,447.40
| Facility | | $8,640.24 | $14,774.92 | $22,447.40 |