- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,325.10 / $9,295.68 / $14,351.70
| Facility | | $6,325.10 | $9,295.68 | $14,351.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,838.99 / $21,095.85 / $27,045.96
| Facility | | $14,838.99 | $21,095.85 | $27,045.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,118.68 / $13,763.31 / $17,408.09
| Facility | | $7,118.68 | $13,763.31 | $17,408.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,325.10 / $9,507.86 / $15,203.50
| Facility | | $6,325.10 | $9,507.86 | $15,203.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,397.14 / $12,649.20 / $19,217.81
| Facility | | $7,397.14 | $12,649.20 | $19,217.81 |