- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,684.63 / $10,412.90 / $14,743.50
| Facility | | $5,684.63 | $10,412.90 | $14,743.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,051.71 / $11,051.71 / $11,322.75
| Facility | | $11,051.71 | $11,051.71 | $11,322.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,934.14 / $9,520.48 / $14,954.76
| Facility | | $5,934.14 | $9,520.48 | $14,954.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,910.30 / $9,366.93 / $16,665.25
| Facility | | $5,910.30 | $9,366.93 | $16,665.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,387.95 / $8,758.26 / $19,706.70
| Facility | | $4,387.95 | $8,758.26 | $19,706.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $8,645.16 / $17,512.40
| Facility | | $3,308.00 | $8,645.16 | $17,512.40 |