- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,057.90 / $11,096.60 / $15,711.60
| Facility | | $6,057.90 | $11,096.60 | $15,711.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,673.31 / $10,878.38 / $17,553.71
| Facility | | $6,673.31 | $10,878.38 | $17,553.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,298.38 / $9,981.98 / $17,759.52
| Facility | | $6,298.38 | $9,981.98 | $17,759.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,676.07 / $9,417.99 / $21,000.67
| Facility | | $4,676.07 | $9,417.99 | $21,000.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,676.07 / $9,731.00 / $21,000.67
| Facility | | $4,676.07 | $9,731.00 | $21,000.67 |