- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,126.11 / $12,867.50 / $21,103.70
| Facility | | $8,126.11 | $12,867.50 | $21,103.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,180.70 / $15,679.02 / $18,550.50
| Facility | | $12,180.70 | $15,679.02 | $18,550.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,505.40 / $12,026.34 / $18,220.16
| Facility | | $7,505.40 | $12,026.34 | $18,220.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,564.00 / $10,691.30 / $18,302.91
| Facility | | $6,564.00 | $10,691.30 | $18,302.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,946.86 / $11,536.06 / $18,302.91
| Facility | | $6,946.86 | $11,536.06 | $18,302.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,970.70 / $14,136.11 / $19,882.47
| Facility | | $5,970.70 | $14,136.11 | $19,882.47 |