- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $12,589.25 / $16,982.44
| Facility | | $6,606.93 | $12,589.25 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $10,471.29 / $16,982.44
| Facility | | $7,079.46 | $10,471.29 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $13,489.63 / $18,197.01
| Facility | | $6,456.54 | $13,489.63 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $9,772.37 / $19,952.62
| Facility | | $4,786.30 | $9,772.37 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $9,549.93 / $19,054.61
| Facility | | $4,073.80 | $9,549.93 | $19,054.61 |