- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,128.54 / $9,006.79 / $13,905.70
| Facility | | $6,128.54 | $9,006.79 | $13,905.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,232.36 / $13,125.18 / $16,827.15
| Facility | | $9,232.36 | $13,125.18 | $16,827.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,897.46 / $13,335.59 / $16,867.09
| Facility | | $6,897.46 | $13,335.59 | $16,867.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,128.54 / $9,212.39 / $14,731.00
| Facility | | $6,128.54 | $9,212.39 | $14,731.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,167.26 / $12,256.10 / $18,620.58
| Facility | | $7,167.26 | $12,256.10 | $18,620.58 |