- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $11,220.18 / $16,595.87
| Facility | | $6,606.93 | $11,220.18 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $9,549.93 / $15,135.61
| Facility | | $6,309.57 | $9,549.93 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $13,182.57 / $17,782.79
| Facility | | $6,309.57 | $13,182.57 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $8,317.64 / $20,892.96
| Facility | | $2,951.21 | $8,317.64 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $7,762.47 / $15,848.93
| Facility | | $2,818.38 | $7,762.47 | $15,848.93 |