- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,117.90 / $8,991.16 / $13,881.60
| Facility | | $6,117.90 | $8,991.16 | $13,881.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,731.36 / $11,731.36 / $11,731.36
| Facility | | $11,731.36 | $11,731.36 | $11,731.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,937.64 / $18,392.79 / $23,580.50
| Facility | | $12,937.64 | $18,392.79 | $23,580.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,885.48 / $13,312.43 / $16,837.81
| Facility | | $6,885.48 | $13,312.43 | $16,837.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,117.90 / $9,196.39 / $14,705.40
| Facility | | $6,117.90 | $9,196.39 | $14,705.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,051.97 / $12,234.82 / $18,588.25
| Facility | | $8,051.97 | $12,234.82 | $18,588.25 |