- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,720.63 / $12,310.60 / $17,430.40
| Facility | | $6,720.63 | $12,310.60 | $17,430.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,216.08 / $11,807.40 / $19,068.36
| Facility | | $7,216.08 | $11,807.40 | $19,068.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,987.42 / $11,074.00 / $19,702.41
| Facility | | $6,987.42 | $11,074.00 | $19,702.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,187.63 / $10,742.63 / $23,298.13
| Facility | | $5,187.63 | $10,742.63 | $23,298.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $10,220.69 / $20,703.93
| Facility | | $3,308.00 | $10,220.69 | $20,703.93 |