- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,489.56 / $11,887.30 / $16,831.09
| Facility | | $6,489.56 | $11,887.30 | $16,831.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,085.48 / $11,491.48 / $18,482.16
| Facility | | $7,085.48 | $11,491.48 | $18,482.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,747.18 / $10,693.26 / $19,025.00
| Facility | | $6,747.18 | $10,693.26 | $19,025.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,009.27 / $10,089.08 / $22,497.10
| Facility | | $5,009.27 | $10,089.08 | $22,497.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $9,869.28 / $19,992.09
| Facility | | $3,308.00 | $9,869.28 | $19,992.09 |