- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,871.71 / $12,587.30 / $17,822.30
| Facility | | $6,871.71 | $12,587.30 | $17,822.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,907.55 / $11,110.83 / $17,755.00
| Facility | | $6,907.55 | $11,110.83 | $17,755.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,144.50 / $11,322.95 / $20,145.33
| Facility | | $7,144.50 | $11,322.95 | $20,145.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $10,683.19 / $23,821.88
| Facility | | $5,264.00 | $10,683.19 | $23,821.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $10,450.45 / $21,169.37
| Facility | | $3,308.00 | $10,450.45 | $21,169.37 |