- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,365.14 / $11,659.40 / $16,508.50
| Facility | | $6,365.14 | $11,659.40 | $16,508.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,817.12 / $9,355.91 / $14,698.94
| Facility | | $5,817.12 | $9,355.91 | $14,698.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,617.82 / $10,488.24 / $18,660.25
| Facility | | $6,617.82 | $10,488.24 | $18,660.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,913.22 / $10,108.08 / $22,065.78
| Facility | | $4,913.22 | $10,108.08 | $22,065.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $9,680.07 / $19,608.80
| Facility | | $3,308.00 | $9,680.07 | $19,608.80 |