- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,827.20 / $8,498.00 / $13,794.90
| Facility | | $5,827.20 | $8,498.00 | $13,794.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,840.75 / $10,173.51 / $13,204.16
| Facility | | $8,840.75 | $10,173.51 | $13,204.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,051.93 / $11,447.01 / $14,675.66
| Facility | | $8,051.93 | $11,447.01 | $14,675.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,842.50 / $13,229.34 / $16,732.72
| Facility | | $6,842.50 | $13,229.34 | $16,732.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,079.71 / $9,138.99 / $14,613.60
| Facility | | $6,079.71 | $9,138.99 | $14,613.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,110.16 / $11,610.70 / $18,259.53
| Facility | | $7,110.16 | $11,610.70 | $18,259.53 |