- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $11,481.54 / $14,791.08
| Facility | | $8,128.31 | $11,481.54 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $10,000.00 / $13,803.84
| Facility | | $6,918.31 | $10,000.00 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $12,022.64 / $16,595.87
| Facility | | $6,309.57 | $12,022.64 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $11,748.98 / $13,803.84
| Facility | | $7,079.46 | $11,748.98 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $12,022.64 / $16,595.87
| Facility | | $6,165.95 | $12,022.64 | $16,595.87 |