- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,215.96 / $11,386.10 / $16,121.50
| Facility | | $6,215.96 | $11,386.10 | $16,121.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,158.41 / $11,576.65 / $18,088.29
| Facility | | $7,158.41 | $11,576.65 | $18,088.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,462.72 / $10,242.43 / $18,222.91
| Facility | | $6,462.72 | $10,242.43 | $18,222.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,798.08 / $9,663.71 / $21,548.63
| Facility | | $4,798.08 | $9,663.71 | $21,548.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $9,453.20 / $19,149.24
| Facility | | $3,308.00 | $9,453.20 | $19,149.24 |