- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,905.35 / $12,648.90 / $17,909.50
| Facility | | $6,905.35 | $12,648.90 | $17,909.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,756.74 / $12,575.20 / $19,903.88
| Facility | | $7,756.74 | $12,575.20 | $19,903.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,179.48 / $11,378.39 / $20,243.96
| Facility | | $7,179.48 | $11,378.39 | $20,243.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $10,865.06 / $23,938.52
| Facility | | $5,264.00 | $10,865.06 | $23,938.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $10,501.62 / $21,273.02
| Facility | | $3,308.00 | $10,501.62 | $21,273.02 |