- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,716.72 / $13,172.10 / $21,410.30
| Facility | | $7,716.72 | $13,172.10 | $21,410.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,769.92 / $14,703.70 / $16,659.81
| Facility | | $12,769.92 | $14,703.70 | $16,659.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,656.86 / $10,465.92 / $16,511.00
| Facility | | $6,656.86 | $10,465.92 | $16,511.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,042.55 / $10,851.44 / $19,998.82
| Facility | | $6,042.55 | $10,851.44 | $19,998.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,164.00 / $11,084.02 / $15,052.98
| Facility | | $6,164.00 | $11,084.02 | $15,052.98 |