- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,757.67 / $9,931.40 / $15,333.20
| Facility | | $6,757.67 | $9,931.40 | $15,333.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,240.88 / $15,980.59 / $20,487.93
| Facility | | $11,240.88 | $15,980.59 | $20,487.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,605.52 / $14,704.56 / $18,598.61
| Facility | | $7,605.52 | $14,704.56 | $18,598.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,757.67 / $10,158.10 / $16,243.20
| Facility | | $6,757.67 | $10,158.10 | $16,243.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,903.02 / $12,921.62 / $20,295.68
| Facility | | $7,903.02 | $12,921.62 | $20,295.68 |