- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,643.82 / $12,169.90 / $17,231.20
| Facility | | $6,643.82 | $12,169.90 | $17,231.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,647.22 / $10,776.45 / $17,056.84
| Facility | | $6,647.22 | $10,776.45 | $17,056.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,907.56 / $10,947.44 / $19,477.23
| Facility | | $6,907.56 | $10,947.44 | $19,477.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.34 / $9,774.20 / $23,031.86
| Facility | | $5,128.34 | $9,774.20 | $23,031.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,395.72 / $10,103.87 / $21,260.66
| Facility | | $4,395.72 | $10,103.87 | $21,260.66 |