- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,828.73 / $10,676.80 / $15,117.20
| Facility | | $5,828.73 | $10,676.80 | $15,117.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,137.34 / $10,130.95 / $14,375.14
| Facility | | $9,137.34 | $10,130.95 | $14,375.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,208.04 / $9,988.87 / $16,008.70
| Facility | | $6,208.04 | $9,988.87 | $16,008.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,060.12 / $9,604.37 / $17,087.70
| Facility | | $6,060.12 | $9,604.37 | $17,087.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,499.18 / $9,044.42 / $20,206.24
| Facility | | $4,499.18 | $9,044.42 | $20,206.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $8,864.29 / $17,956.32
| Facility | | $3,308.00 | $8,864.29 | $17,956.32 |