- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,553.59 / $9,631.48 / $14,870.20
| Facility | | $6,553.59 | $9,631.48 | $14,870.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,134.71 / $22,937.90 / $29,407.56
| Facility | | $16,134.71 | $22,937.90 | $29,407.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,375.84 / $14,260.49 / $18,036.95
| Facility | | $7,375.84 | $14,260.49 | $18,036.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,553.59 / $9,851.33 / $15,752.70
| Facility | | $6,553.59 | $9,851.33 | $15,752.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,664.35 / $13,106.14 / $19,912.04
| Facility | | $7,664.35 | $13,106.14 | $19,912.04 |