- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,022.16 / $12,862.90 / $18,212.50
| Facility | | $7,022.16 | $12,862.90 | $18,212.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,992.21 / $11,242.37 / $17,972.61
| Facility | | $6,992.21 | $11,242.37 | $17,972.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,300.92 / $14,778.83 / $26,789.95
| Facility | | $7,300.92 | $14,778.83 | $26,789.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $10,330.79 / $24,343.44
| Facility | | $5,264.00 | $10,330.79 | $24,343.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $10,679.25 / $21,632.85
| Facility | | $3,308.00 | $10,679.25 | $21,632.85 |