- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,754.91 / $12,373.40 / $17,519.30
| Facility | | $6,754.91 | $12,373.40 | $17,519.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,173.00 / $11,628.85 / $18,406.00
| Facility | | $7,173.00 | $11,628.85 | $18,406.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,023.06 / $11,130.49 / $19,802.90
| Facility | | $7,023.06 | $11,130.49 | $19,802.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,214.09 / $10,501.60 / $23,416.97
| Facility | | $5,214.09 | $10,501.60 | $23,416.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $10,272.82 / $20,809.54
| Facility | | $3,308.00 | $10,272.82 | $20,809.54 |