- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,329.70 / $9,243.24 / $12,148.80
| Facility | | $6,329.70 | $9,243.24 | $12,148.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,926.89 / $10,694.39 / $18,088.12
| Facility | | $3,926.89 | $10,694.39 | $18,088.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,729.05 / $9,284.32 / $15,539.85
| Facility | | $6,729.05 | $9,284.32 | $15,539.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,961.90 / $10,361.42 / $15,128.52
| Facility | | $7,961.90 | $10,361.42 | $15,128.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,961.90 / $9,632.32 / $15,128.52
| Facility | | $7,961.90 | $9,632.32 | $15,128.52 |