- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $12,022.64 / $22,908.68
| Facility | | $7,762.47 | $12,022.64 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $11,748.98 / $15,488.17
| Facility | | $9,549.93 | $11,748.98 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $10,232.93 / $27,542.29
| Facility | | $7,762.47 | $10,232.93 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $7,943.28 / $16,218.10
| Facility | | $3,801.89 | $7,943.28 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $10,715.19 / $15,135.61
| Facility | | $5,495.41 | $10,715.19 | $15,135.61 |