- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,520.42 / $9,582.71 / $14,794.90
| Facility | | $6,520.42 | $9,582.71 | $14,794.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,445.06 / $13,427.57 / $17,214.83
| Facility | | $9,445.06 | $13,427.57 | $17,214.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,338.50 / $14,188.30 / $17,945.63
| Facility | | $7,338.50 | $14,188.30 | $17,945.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,520.42 / $9,801.45 / $15,673.00
| Facility | | $6,520.42 | $9,801.45 | $15,673.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,625.55 / $13,039.79 / $19,811.23
| Facility | | $7,625.55 | $13,039.79 | $19,811.23 |