- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,246.85 / $9,180.68 / $14,174.20
| Facility | | $6,246.85 | $9,180.68 | $14,174.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,856.48 / $11,856.48 / $14,368.56
| Facility | | $11,856.48 | $11,856.48 | $14,368.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,409.54 / $14,798.71 / $18,972.71
| Facility | | $10,409.54 | $14,798.71 | $18,972.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,030.61 / $13,593.03 / $17,192.73
| Facility | | $7,030.61 | $13,593.03 | $17,192.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,246.85 / $9,390.24 / $15,015.40
| Facility | | $6,246.85 | $9,390.24 | $15,015.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,305.63 / $11,929.89 / $18,761.52
| Facility | | $7,305.63 | $11,929.89 | $18,761.52 |