- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,225.48 / $11,403.60 / $16,146.20
| Facility | | $6,225.48 | $11,403.60 | $16,146.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,751.88 / $10,751.88 / $10,751.88
| Facility | | $10,751.88 | $10,751.88 | $10,751.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,857.11 / $11,116.73 / $17,595.41
| Facility | | $6,857.11 | $11,116.73 | $17,595.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,472.62 / $10,258.12 / $18,250.83
| Facility | | $6,472.62 | $10,258.12 | $18,250.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,805.43 / $9,678.53 / $21,581.64
| Facility | | $4,805.43 | $9,678.53 | $21,581.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $9,467.68 / $19,178.57
| Facility | | $3,308.00 | $9,467.68 | $19,178.57 |