- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,325.45 / $10,765.80 / $16,621.50
| Facility | | $7,325.45 | $10,765.80 | $16,621.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,765.93 / $20,991.97 / $26,912.78
| Facility | | $14,765.93 | $20,991.97 | $26,912.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,244.54 / $15,940.04 / $20,161.27
| Facility | | $8,244.54 | $15,940.04 | $20,161.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,325.45 / $11,011.60 / $17,608.00
| Facility | | $7,325.45 | $11,011.60 | $17,608.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,567.03 / $14,649.73 / $22,257.20
| Facility | | $8,567.03 | $14,649.73 | $22,257.20 |