- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,838.89 / $10,695.40 / $15,143.60
| Facility | | $5,838.89 | $10,695.40 | $15,143.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,204.11 / $9,833.54 / $15,609.15
| Facility | | $6,204.11 | $9,833.54 | $15,609.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,070.68 / $9,621.11 / $17,117.48
| Facility | | $6,070.68 | $9,621.11 | $17,117.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,507.02 / $9,077.51 / $20,241.45
| Facility | | $4,507.02 | $9,077.51 | $20,241.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $8,879.75 / $17,987.61
| Facility | | $3,308.00 | $8,879.75 | $17,987.61 |