- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.19 / $13,579.20 / $19,226.70
| Facility | | $7,413.19 | $13,579.20 | $19,226.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,475.50 / $12,005.05 / $18,889.98
| Facility | | $7,475.50 | $12,005.05 | $18,889.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,707.48 / $12,215.19 / $21,732.76
| Facility | | $7,707.48 | $12,215.19 | $21,732.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $11,273.94 / $25,699.03
| Facility | | $5,264.00 | $11,273.94 | $25,699.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $11,273.94 / $22,837.50
| Facility | | $3,308.00 | $11,273.94 | $22,837.50 |