- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $11,748.98 / $16,218.10
| Facility | | $6,309.57 | $11,748.98 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $11,481.54 / $18,620.87
| Facility | | $7,413.10 | $11,481.54 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $12,589.25 / $26,915.35
| Facility | | $6,165.95 | $12,589.25 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $9,772.37 / $20,892.96
| Facility | | $5,248.07 | $9,772.37 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $9,549.93 / $21,379.62
| Facility | | $3,890.45 | $9,549.93 | $21,379.62 |