- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,480.37 / $14,067.50 / $18,877.50
| Facility | | $8,480.37 | $14,067.50 | $18,877.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,653.03 / $8,078.74 / $12,592.48
| Facility | | $7,653.03 | $8,078.74 | $12,592.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,776.94 / $11,927.12 / $18,754.73
| Facility | | $6,776.94 | $11,927.12 | $18,754.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,963.53 / $11,326.50 / $25,976.20
| Facility | | $6,963.53 | $11,326.50 | $25,976.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,219.41 / $11,157.36 / $16,000.57
| Facility | | $8,219.41 | $11,157.36 | $16,000.57 |