- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $12,022.64 / $18,620.87
| Facility | | $5,888.44 | $12,022.64 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $10,715.19 / $18,197.01
| Facility | | $7,585.78 | $10,715.19 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $15,848.93 / $25,118.86
| Facility | | $9,772.37 | $15,848.93 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $10,232.93 / $33,113.11
| Facility | | $5,370.32 | $10,232.93 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $9,549.93 / $16,218.10
| Facility | | $5,370.32 | $9,549.93 | $16,218.10 |