- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,884.12 / $10,117.20 / $15,620.10
| Facility | | $6,884.12 | $10,117.20 | $15,620.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,720.07 / $18,083.47 / $23,183.94
| Facility | | $12,720.07 | $18,083.47 | $23,183.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,747.84 / $14,979.72 / $18,946.63
| Facility | | $7,747.84 | $14,979.72 | $18,946.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,884.12 / $10,348.20 / $16,547.20
| Facility | | $6,884.12 | $10,348.20 | $16,547.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,050.90 / $13,767.14 / $20,916.29
| Facility | | $8,050.90 | $13,767.14 | $20,916.29 |