- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,454.69 / $9,486.12 / $14,645.70
| Facility | | $6,454.69 | $9,486.12 | $14,645.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,004.41 / $19,909.37 / $25,524.83
| Facility | | $14,004.41 | $19,909.37 | $25,524.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,264.52 / $14,045.27 / $17,764.73
| Facility | | $7,264.52 | $14,045.27 | $17,764.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,454.69 / $9,702.65 / $15,515.00
| Facility | | $6,454.69 | $9,702.65 | $15,515.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,548.68 / $12,908.34 / $19,611.52
| Facility | | $7,548.68 | $12,908.34 | $19,611.52 |