- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,447.52 / $10,945.20 / $16,898.50
| Facility | | $7,447.52 | $10,945.20 | $16,898.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,276.60 / $16,031.36 / $20,553.03
| Facility | | $11,276.60 | $16,031.36 | $20,553.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,381.92 / $16,205.67 / $20,497.23
| Facility | | $8,381.92 | $16,205.67 | $20,497.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,447.52 / $11,195.10 / $17,901.40
| Facility | | $7,447.52 | $11,195.10 | $17,901.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.79 / $14,893.85 / $22,628.09
| Facility | | $8,709.79 | $14,893.85 | $22,628.09 |