- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,180.22 / $13,152.40 / $18,622.40
| Facility | | $7,180.22 | $13,152.40 | $18,622.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,913.09 / $12,830.77 / $20,589.34
| Facility | | $7,913.09 | $12,830.77 | $20,589.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,465.26 / $11,831.31 / $21,049.77
| Facility | | $7,465.26 | $11,831.31 | $21,049.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $11,059.02 / $24,891.39
| Facility | | $5,264.00 | $11,059.02 | $24,891.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $10,919.64 / $22,119.79
| Facility | | $3,308.00 | $10,919.64 | $22,119.79 |