- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,180.70 / $13,964.10 / $22,697.60
| Facility | | $8,180.70 | $13,964.10 | $22,697.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,079.11 / $11,479.44 / $17,143.89
| Facility | | $11,079.11 | $11,479.44 | $17,143.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,014.90 / $11,095.20 / $17,503.75
| Facility | | $7,014.90 | $11,095.20 | $17,503.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,411.90 / $11,414.16 / $21,151.50
| Facility | | $6,411.90 | $11,414.16 | $21,151.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,164.00 / $11,750.46 / $15,958.06
| Facility | | $6,164.00 | $11,750.46 | $15,958.06 |