- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,530.63 / $13,794.30 / $19,531.20
| Facility | | $7,530.63 | $13,794.30 | $19,531.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,702.96 / $12,209.23 / $19,380.16
| Facility | | $7,702.96 | $12,209.23 | $19,380.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,829.58 / $12,408.70 / $22,077.04
| Facility | | $7,829.58 | $12,408.70 | $22,077.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $11,806.98 / $26,106.14
| Facility | | $5,264.00 | $11,806.98 | $26,106.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $11,452.54 / $23,199.28
| Facility | | $3,308.00 | $11,452.54 | $23,199.28 |