- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,481.31 / $11,872.20 / $16,809.70
| Facility | | $6,481.31 | $11,872.20 | $16,809.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,348.37 / $11,912.69 / $19,203.91
| Facility | | $7,348.37 | $11,912.69 | $19,203.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,738.60 / $10,679.66 / $19,000.81
| Facility | | $6,738.60 | $10,679.66 | $19,000.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,002.89 / $10,087.14 / $22,468.49
| Facility | | $5,002.89 | $10,087.14 | $22,468.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $9,856.73 / $19,966.68
| Facility | | $3,308.00 | $9,856.73 | $19,966.68 |