- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,841.87 / $12,532.70 / $17,744.90
| Facility | | $6,841.87 | $12,532.70 | $17,744.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,129.55 / $11,569.52 / $18,668.95
| Facility | | $7,129.55 | $11,569.52 | $18,668.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,113.48 / $11,273.79 / $20,057.86
| Facility | | $7,113.48 | $11,273.79 | $20,057.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $10,172.10 / $23,718.45
| Facility | | $5,264.00 | $10,172.10 | $23,718.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $10,405.08 / $21,077.46
| Facility | | $3,308.00 | $10,405.08 | $21,077.46 |