- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $11,481.54 / $15,135.61
| Facility | | $6,760.83 | $11,481.54 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $11,748.98 / $16,595.87
| Facility | | $8,317.64 | $11,748.98 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $12,882.50 / $16,982.44
| Facility | | $7,943.28 | $12,882.50 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $11,481.54 / $18,197.01
| Facility | | $7,943.28 | $11,481.54 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $8,511.38 / $19,952.62
| Facility | | $4,168.69 | $8,511.38 | $19,952.62 |