- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,551.72 / $9,628.71 / $14,865.90
| Facility | | $6,551.72 | $9,628.71 | $14,865.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,140.40 / $17,259.40 / $22,127.43
| Facility | | $12,140.40 | $17,259.40 | $22,127.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,077.90 / $13,734.53 / $18,031.78
| Facility | | $2,077.90 | $13,734.53 | $18,031.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,551.72 / $9,848.51 / $15,748.20
| Facility | | $6,551.72 | $9,848.51 | $15,748.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,662.16 / $12,512.10 / $19,677.13
| Facility | | $7,662.16 | $12,512.10 | $19,677.13 |