- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,543.52 / $11,986.10 / $16,971.09
| Facility | | $6,543.52 | $11,986.10 | $16,971.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,373.28 / $7,373.28 / $10,463.01
| Facility | | $7,373.28 | $7,373.28 | $10,463.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,900.68 / $11,063.46 / $17,401.38
| Facility | | $6,900.68 | $11,063.46 | $17,401.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,803.28 / $10,782.17 / $19,183.18
| Facility | | $6,803.28 | $10,782.17 | $19,183.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,050.92 / $10,215.52 / $22,684.16
| Facility | | $5,050.92 | $10,215.52 | $22,684.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $9,951.34 / $20,158.32
| Facility | | $3,308.00 | $9,951.34 | $20,158.32 |