- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,384.63 / $13,526.90 / $19,152.59
| Facility | | $7,384.63 | $13,526.90 | $19,152.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,509.69 / $12,232.09 / $19,115.48
| Facility | | $7,509.69 | $12,232.09 | $19,115.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,677.78 / $12,168.12 / $21,649.01
| Facility | | $7,677.78 | $12,168.12 | $21,649.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $11,480.61 / $25,600.00
| Facility | | $5,264.00 | $11,480.61 | $25,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $10,396.12 / $22,749.49
| Facility | | $3,308.00 | $10,396.12 | $22,749.49 |