- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,838.41 / $10,110.40 / $16,785.59
| Facility | | $6,838.41 | $10,110.40 | $16,785.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,902.70 / $8,842.60 / $14,979.55
| Facility | | $5,902.70 | $8,842.60 | $14,979.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,579.00 / $10,783.86 / $15,505.87
| Facility | | $8,579.00 | $10,783.86 | $15,505.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,417.50 / $10,826.33 / $26,394.57
| Facility | | $5,417.50 | $10,826.33 | $26,394.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,417.50 / $10,336.59 / $14,527.57
| Facility | | $5,417.50 | $10,336.59 | $14,527.57 |