- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,203.90 / $11,364.00 / $16,090.30
| Facility | | $6,203.90 | $11,364.00 | $16,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,894.05 / $11,129.43 / $17,836.59
| Facility | | $6,894.05 | $11,129.43 | $17,836.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,450.18 / $10,222.56 / $18,187.55
| Facility | | $6,450.18 | $10,222.56 | $18,187.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,788.77 / $9,644.96 / $21,506.82
| Facility | | $4,788.77 | $9,644.96 | $21,506.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $8,658.20 / $19,112.08
| Facility | | $3,308.00 | $8,658.20 | $19,112.08 |