- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,817.94 / $10,657.10 / $15,089.30
| Facility | | $5,817.94 | $10,657.10 | $15,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,331.86 / $10,184.83 / $16,275.26
| Facility | | $6,331.86 | $10,184.83 | $16,275.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,048.90 / $9,586.59 / $17,056.07
| Facility | | $6,048.90 | $9,586.59 | $17,056.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,490.85 / $9,149.28 / $20,168.83
| Facility | | $4,490.85 | $9,149.28 | $20,168.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $8,847.89 / $17,923.07
| Facility | | $3,308.00 | $8,847.89 | $17,923.07 |