- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,884.20 / $8,581.12 / $13,929.90
| Facility | | $5,884.20 | $8,581.12 | $13,929.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,271.06 / $12,219.39 / $20,282.16
| Facility | | $9,271.06 | $12,219.39 | $20,282.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,906.79 / $18,348.93 / $23,524.27
| Facility | | $12,906.79 | $18,348.93 | $23,524.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,909.43 / $13,358.74 / $16,896.39
| Facility | | $6,909.43 | $13,358.74 | $16,896.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,139.18 / $9,228.39 / $14,756.60
| Facility | | $6,139.18 | $9,228.39 | $14,756.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,179.70 / $12,277.38 / $18,652.91
| Facility | | $7,179.70 | $12,277.38 | $18,652.91 |