- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,031.68 / $12,880.30 / $18,237.20
| Facility | | $7,031.68 | $12,880.30 | $18,237.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.39 / $11,594.87 / $13,909.67
| Facility | | $7,943.39 | $11,594.87 | $13,909.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,012.88 / $12,995.57 / $20,901.25
| Facility | | $8,012.88 | $12,995.57 | $20,901.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,310.82 / $11,586.54 / $20,614.30
| Facility | | $7,310.82 | $11,586.54 | $20,614.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $10,931.89 / $24,376.44
| Facility | | $5,264.00 | $10,931.89 | $24,376.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $10,693.74 / $21,662.18
| Facility | | $3,308.00 | $10,693.74 | $21,662.18 |