- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,645.72 / $12,173.40 / $17,236.20
| Facility | | $6,645.72 | $12,173.40 | $17,236.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,682.65 / $14,041.06 / $23,224.93
| Facility | | $8,682.65 | $14,041.06 | $23,224.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,909.54 / $10,950.57 / $19,482.81
| Facility | | $6,909.54 | $10,950.57 | $19,482.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,129.81 / $10,582.04 / $23,038.46
| Facility | | $5,129.81 | $10,582.04 | $23,038.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $10,106.77 / $20,473.18
| Facility | | $3,308.00 | $10,106.77 | $20,473.18 |