- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $13,182.57 / $17,782.79
| Facility | | $6,918.31 | $13,182.57 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $10,964.78 / $10,964.78
| Facility | | $10,964.78 | $10,964.78 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $10,715.19 / $17,378.01
| Facility | | $7,079.46 | $10,715.19 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $14,125.38 / $19,054.61
| Facility | | $6,760.83 | $14,125.38 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $10,232.93 / $20,892.96
| Facility | | $5,011.87 | $10,232.93 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $10,232.93 / $19,952.62
| Facility | | $4,265.80 | $10,232.93 | $19,952.62 |