- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $10,964.78 / $20,892.96
| Facility | | $7,079.46 | $10,964.78 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $10,964.78 / $14,125.38
| Facility | | $6,918.31 | $10,964.78 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $9,332.54 / $15,135.61
| Facility | | $6,165.95 | $9,332.54 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $9,549.93 / $17,782.79
| Facility | | $5,128.61 | $9,549.93 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $10,000.00 / $14,125.38
| Facility | | $5,754.40 | $10,000.00 | $14,125.38 |