- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,017.74 / $8,843.95 / $13,654.30
| Facility | | $6,017.74 | $8,843.95 | $13,654.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,956.94 / $12,062.28 / $17,619.98
| Facility | | $9,956.94 | $12,062.28 | $17,619.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,393.50 / $16,197.57 / $20,766.11
| Facility | | $11,393.50 | $16,197.57 | $20,766.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,772.75 / $13,094.48 / $16,562.15
| Facility | | $6,772.75 | $13,094.48 | $16,562.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,017.74 / $9,045.83 / $14,464.70
| Facility | | $6,017.74 | $9,045.83 | $14,464.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,037.68 / $12,034.51 / $18,283.93
| Facility | | $7,037.68 | $12,034.51 | $18,283.93 |