- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,399.60 / $9,405.16 / $14,520.70
| Facility | | $6,399.60 | $9,405.16 | $14,520.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,945.56 / $16,982.40 / $21,772.31
| Facility | | $11,945.56 | $16,982.40 | $21,772.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,202.52 / $14,045.18 / $20,402.04
| Facility | | $7,202.52 | $14,045.18 | $20,402.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,399.60 / $9,619.84 / $15,382.50
| Facility | | $6,399.60 | $9,619.84 | $15,382.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,233.45 / $12,798.17 / $19,444.15
| Facility | | $8,233.45 | $12,798.17 | $19,444.15 |