- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,814.77 / $10,651.20 / $15,081.00
| Facility | | $5,814.77 | $10,651.20 | $15,081.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,160.74 / $9,814.98 / $15,500.04
| Facility | | $6,160.74 | $9,814.98 | $15,500.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,045.60 / $9,581.36 / $17,046.75
| Facility | | $6,045.60 | $9,581.36 | $17,046.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,488.39 / $9,052.26 / $20,157.83
| Facility | | $4,488.39 | $9,052.26 | $20,157.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $8,843.06 / $17,913.30
| Facility | | $3,308.00 | $8,843.06 | $17,913.30 |