- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,229.60 / $7,626.50 / $12,380.20
| Facility | | $5,229.60 | $7,626.50 | $12,380.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,186.23 / $10,246.54 / $18,420.98
| Facility | | $9,186.23 | $10,246.54 | $18,420.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,325.31 / $16,100.62 / $20,641.82
| Facility | | $11,325.31 | $16,100.62 | $20,641.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,140.78 / $11,872.62 / $15,016.72
| Facility | | $6,140.78 | $11,872.62 | $15,016.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,456.22 / $8,201.76 / $13,115.00
| Facility | | $5,456.22 | $8,201.76 | $13,115.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,380.98 / $10,911.56 / $16,577.83
| Facility | | $6,380.98 | $10,911.56 | $16,577.83 |