- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,413.38 / $11,747.80 / $16,633.59
| Facility | | $6,413.38 | $11,747.80 | $16,633.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,192.91 / $10,435.37 / $16,199.54
| Facility | | $7,192.91 | $10,435.37 | $16,199.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,192.56 / $11,662.46 / $18,697.97
| Facility | | $7,192.56 | $11,662.46 | $18,697.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,667.98 / $10,567.74 / $18,801.68
| Facility | | $6,667.98 | $10,567.74 | $18,801.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,950.47 / $9,970.65 / $22,233.03
| Facility | | $4,950.47 | $9,970.65 | $22,233.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $9,753.44 / $19,757.43
| Facility | | $3,308.00 | $9,753.44 | $19,757.43 |