- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,012.73 / $8,836.60 / $13,642.90
| Facility | | $6,012.73 | $8,836.60 | $13,642.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,678.68 / $12,338.03 / $15,817.99
| Facility | | $8,678.68 | $12,338.03 | $15,817.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,767.12 / $13,083.59 / $16,548.37
| Facility | | $6,767.12 | $13,083.59 | $16,548.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,012.73 / $9,038.29 / $14,452.60
| Facility | | $6,012.73 | $9,038.29 | $14,452.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,031.82 / $12,024.50 / $18,268.71
| Facility | | $7,031.82 | $12,024.50 | $18,268.71 |