- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,887.53 / $8,652.60 / $13,358.90
| Facility | | $5,887.53 | $8,652.60 | $13,358.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,219.57 / $14,528.64 / $18,626.46
| Facility | | $10,219.57 | $14,528.64 | $18,626.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,626.21 / $12,811.15 / $16,203.79
| Facility | | $6,626.21 | $12,811.15 | $16,203.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,887.53 / $8,850.11 / $14,151.70
| Facility | | $5,887.53 | $8,850.11 | $14,151.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,885.40 / $11,774.12 / $17,888.31
| Facility | | $6,885.40 | $11,774.12 | $17,888.31 |