- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,612.08 / $12,111.70 / $17,148.90
| Facility | | $6,612.08 | $12,111.70 | $17,148.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,841.45 / $11,027.12 / $17,350.61
| Facility | | $6,841.45 | $11,027.12 | $17,350.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,874.56 / $10,895.14 / $19,384.18
| Facility | | $6,874.56 | $10,895.14 | $19,384.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,103.84 / $10,132.87 / $22,921.82
| Facility | | $5,103.84 | $10,132.87 | $22,921.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $10,055.61 / $20,369.53
| Facility | | $3,308.00 | $10,055.61 | $20,369.53 |