- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,973.91 / $12,774.50 / $18,087.40
| Facility | | $6,973.91 | $12,774.50 | $18,087.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,248.00 / $11,626.51 / $18,281.66
| Facility | | $7,248.00 | $11,626.51 | $18,281.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,250.76 / $11,491.36 / $20,444.95
| Facility | | $7,250.76 | $11,491.36 | $20,444.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $10,842.08 / $24,176.19
| Facility | | $5,264.00 | $10,842.08 | $24,176.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $10,605.88 / $21,484.22
| Facility | | $3,308.00 | $10,605.88 | $21,484.22 |