- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,584.85 / $12,947.10 / $21,044.40
| Facility | | $7,584.85 | $12,947.10 | $21,044.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,748.82 / $13,075.97 / $16,004.25
| Facility | | $8,748.82 | $13,075.97 | $16,004.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,503.96 / $10,287.07 / $16,228.85
| Facility | | $6,503.96 | $10,287.07 | $16,228.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,043.03 / $11,293.42 / $20,705.11
| Facility | | $6,043.03 | $11,293.42 | $20,705.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,164.00 / $10,894.61 / $14,795.74
| Facility | | $6,164.00 | $10,894.61 | $14,795.74 |