- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,991.73 / $11,670.30 / $15,338.80
| Facility | | $7,991.73 | $11,670.30 | $15,338.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,777.71 / $7,564.76 / $12,794.78
| Facility | | $2,777.71 | $7,564.76 | $12,794.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,118.50 / $11,722.16 / $19,620.25
| Facility | | $8,118.50 | $11,722.16 | $19,620.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,052.51 / $13,082.09 / $19,100.91
| Facility | | $10,052.51 | $13,082.09 | $19,100.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,052.51 / $12,161.55 / $19,100.91
| Facility | | $10,052.51 | $12,161.55 | $19,100.91 |