- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,952.89 / $10,804.70 / $15,177.70
| Facility | | $7,952.89 | $10,804.70 | $15,177.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,295.04 / $10,011.54 / $15,185.50
| Facility | | $6,295.04 | $10,011.54 | $15,185.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,937.87 / $9,578.14 / $17,336.00
| Facility | | $6,937.87 | $9,578.14 | $17,336.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.75 / $102.05 / $172.02
| Facility | | $73.75 | $102.05 | $172.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,641.71 / $10,575.83 / $17,405.34
| Facility | | $7,641.71 | $10,575.83 | $17,405.34 |