- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,809.63 / $10,007.79 / $15,451.10
| Facility | | $6,809.63 | $10,007.79 | $15,451.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,468.19 / $16,303.75 / $20,902.24
| Facility | | $11,468.19 | $16,303.75 | $20,902.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,664.00 / $14,817.62 / $18,741.61
| Facility | | $7,664.00 | $14,817.62 | $18,741.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,809.63 / $10,236.20 / $16,368.10
| Facility | | $6,809.63 | $10,236.20 | $16,368.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,963.78 / $13,618.17 / $20,689.96
| Facility | | $7,963.78 | $13,618.17 | $20,689.96 |