- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,924.29 / $13,526.50 / $21,986.20
| Facility | | $7,924.29 | $13,526.50 | $21,986.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,800.29 / $11,339.00 / $14,362.22
| Facility | | $10,800.29 | $11,339.00 | $14,362.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,830.00 / $10,747.44 / $16,955.13
| Facility | | $6,830.00 | $10,747.44 | $16,955.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,265.45 / $12,314.25 / $24,040.26
| Facility | | $6,265.45 | $12,314.25 | $24,040.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,164.00 / $11,382.16 / $15,457.88
| Facility | | $6,164.00 | $11,382.16 | $15,457.88 |