- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,590.88 / $10,445.10 / $17,341.40
| Facility | | $6,590.88 | $10,445.10 | $17,341.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,483.75 / $9,248.46 / $11,188.11
| Facility | | $6,483.75 | $9,248.46 | $11,188.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,216.37 / $9,516.28 / $15,775.57
| Facility | | $6,216.37 | $9,516.28 | $15,775.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,158.90 / $10,638.54 / $16,019.28
| Facility | | $8,158.90 | $10,638.54 | $16,019.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,596.88 / $11,184.80 / $27,797.18
| Facility | | $5,596.88 | $11,184.80 | $27,797.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,596.88 / $10,678.84 / $15,008.58
| Facility | | $5,596.88 | $10,678.84 | $15,008.58 |