- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,617.70 / $10,690.70 / $14,793.20
| Facility | | $6,617.70 | $10,690.70 | $14,793.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,945.03 / $9,085.00 / $13,482.87
| Facility | | $4,945.03 | $9,085.00 | $13,482.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,182.76 / $9,795.12 / $14,839.83
| Facility | | $6,182.76 | $9,795.12 | $14,839.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,385.51 / $8,944.16 / $15,311.92
| Facility | | $6,385.51 | $8,944.16 | $15,311.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,564.00 / $8,833.16 / $14,490.37
| Facility | | $6,564.00 | $8,833.16 | $14,490.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,040.80 / $11,513.49 / $16,799.46
| Facility | | $6,040.80 | $11,513.49 | $16,799.46 |