- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,472.42 / $11,855.90 / $16,786.70
| Facility | | $6,472.42 | $11,855.90 | $16,786.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,169.20 / $11,534.23 / $18,124.93
| Facility | | $7,169.20 | $11,534.23 | $18,124.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,729.36 / $10,665.02 / $18,974.75
| Facility | | $6,729.36 | $10,665.02 | $18,974.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,996.04 / $10,335.08 / $22,437.68
| Facility | | $4,996.04 | $10,335.08 | $22,437.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $9,843.21 / $19,939.30
| Facility | | $3,308.00 | $9,843.21 | $19,939.30 |