- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,703.83 / $9,852.28 / $15,211.10
| Facility | | $6,703.83 | $9,852.28 | $15,211.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,362.65 / $16,153.71 / $20,709.88
| Facility | | $11,362.65 | $16,153.71 | $20,709.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $751.19 / $14,053.42 / $18,450.43
| Facility | | $751.19 | $14,053.42 | $18,450.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,703.83 / $10,077.20 / $16,113.80
| Facility | | $6,703.83 | $10,077.20 | $16,113.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,840.06 / $13,406.60 / $20,368.52
| Facility | | $7,840.06 | $13,406.60 | $20,368.52 |