- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,775.41 / $10,579.20 / $14,978.90
| Facility | | $5,775.41 | $10,579.20 | $14,978.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,268.37 / $10,065.82 / $16,112.06
| Facility | | $6,268.37 | $10,065.82 | $16,112.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,004.68 / $9,516.51 / $16,931.38
| Facility | | $6,004.68 | $9,516.51 | $16,931.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,458.02 / $9,216.90 / $20,021.39
| Facility | | $4,458.02 | $9,216.90 | $20,021.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $8,783.20 / $17,792.05
| Facility | | $3,308.00 | $8,783.20 | $17,792.05 |