- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,494.00 / $11,895.40 / $16,842.70
| Facility | | $6,494.00 | $11,895.40 | $16,842.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,744.02 / $10,810.67 / $17,012.29
| Facility | | $6,744.02 | $10,810.67 | $17,012.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,751.80 / $10,700.58 / $19,038.03
| Facility | | $6,751.80 | $10,700.58 | $19,038.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,012.70 / $10,191.58 / $22,512.51
| Facility | | $5,012.70 | $10,191.58 | $22,512.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $9,876.04 / $20,005.79
| Facility | | $3,308.00 | $9,876.04 | $20,005.79 |