- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,980.90 / $12,787.30 / $18,105.50
| Facility | | $6,980.90 | $12,787.30 | $18,105.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,974.25 / $11,135.55 / $17,558.73
| Facility | | $6,974.25 | $11,135.55 | $17,558.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,258.02 / $11,502.86 / $20,465.41
| Facility | | $7,258.02 | $11,502.86 | $20,465.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $10,852.94 / $24,200.39
| Facility | | $5,264.00 | $10,852.94 | $24,200.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $10,616.50 / $21,505.73
| Facility | | $3,308.00 | $10,616.50 | $21,505.73 |