- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,252.38 / $6,330.03 / $13,245.60
| Facility | | $6,252.38 | $6,330.03 | $13,245.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,360.51 / $11,498.57 / $15,428.60
| Facility | | $8,360.51 | $11,498.57 | $15,428.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,849.97 / $9,406.83 / $13,186.83
| Facility | | $6,849.97 | $9,406.83 | $13,186.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,963.52 / $10,447.34 / $13,170.68
| Facility | | $5,963.52 | $10,447.34 | $13,170.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,963.52 / $10,534.31 / $13,813.62
| Facility | | $5,963.52 | $10,534.31 | $13,813.62 |