- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,181.49 / $13,154.80 / $18,625.70
| Facility | | $7,181.49 | $13,154.80 | $18,625.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,684.66 / $12,458.34 / $19,718.91
| Facility | | $7,684.66 | $12,458.34 | $19,718.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,466.58 / $11,833.40 / $21,053.49
| Facility | | $7,466.58 | $11,833.40 | $21,053.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $10,921.57 / $24,895.80
| Facility | | $5,264.00 | $10,921.57 | $24,895.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $10,921.57 / $22,123.70
| Facility | | $3,308.00 | $10,921.57 | $22,123.70 |