- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,349.27 / $11,630.30 / $16,467.30
| Facility | | $6,349.27 | $11,630.30 | $16,467.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,606.52 / $12,308.46 / $19,726.16
| Facility | | $7,606.52 | $12,308.46 | $19,726.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,601.32 / $10,462.09 / $18,613.72
| Facility | | $6,601.32 | $10,462.09 | $18,613.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,900.97 / $9,972.48 / $22,010.76
| Facility | | $4,900.97 | $9,972.48 | $22,010.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $9,655.93 / $19,559.91
| Facility | | $3,308.00 | $9,655.93 | $19,559.91 |