- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,878.06 / $12,598.90 / $17,838.70
| Facility | | $6,878.06 | $12,598.90 | $17,838.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,494.95 / $12,155.58 / $19,550.27
| Facility | | $7,494.95 | $12,155.58 | $19,550.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,151.10 / $11,333.41 / $20,163.93
| Facility | | $7,151.10 | $11,333.41 | $20,163.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $10,673.18 / $23,843.89
| Facility | | $5,264.00 | $10,673.18 | $23,843.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $10,460.11 / $21,188.93
| Facility | | $3,308.00 | $10,460.11 | $21,188.93 |