- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $8,511.38 / $14,125.38
| Facility | | $6,918.31 | $8,511.38 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $7,943.28 / $20,417.38
| Facility | | $6,309.57 | $7,943.28 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $8,317.64 / $13,803.84
| Facility | | $4,897.79 | $8,317.64 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $10,964.78 / $14,454.40
| Facility | | $7,079.46 | $10,964.78 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $10,232.93 / $15,848.93
| Facility | | $7,079.46 | $10,232.93 | $15,848.93 |