- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,127.72 / $11,224.50 / $15,892.70
| Facility | | $6,127.72 | $11,224.50 | $15,892.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,476.31 / $9,476.31 / $9,476.31
| Facility | | $9,476.31 | $9,476.31 | $9,476.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,580.82 / $10,629.31 / $17,035.08
| Facility | | $6,580.82 | $10,629.31 | $17,035.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,370.98 / $10,097.04 / $17,964.23
| Facility | | $6,370.98 | $10,097.04 | $17,964.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,729.97 / $9,507.29 / $21,242.74
| Facility | | $4,729.97 | $9,507.29 | $21,242.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $9,319.01 / $18,877.41
| Facility | | $3,308.00 | $9,319.01 | $18,877.41 |