- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,513.05 / $11,930.30 / $16,892.09
| Facility | | $6,513.05 | $11,930.30 | $16,892.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,454.62 / $7,454.62 / $7,454.62
| Facility | | $7,454.62 | $7,454.62 | $7,454.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,993.50 / $11,337.85 / $17,945.41
| Facility | | $6,993.50 | $11,337.85 | $17,945.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,771.60 / $10,731.96 / $19,093.86
| Facility | | $6,771.60 | $10,731.96 | $19,093.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,027.39 / $10,327.24 / $22,578.53
| Facility | | $5,027.39 | $10,327.24 | $22,578.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $9,286.29 / $20,064.46
| Facility | | $3,308.00 | $9,286.29 | $20,064.46 |