- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,358.60 / $13,479.20 / $19,085.09
| Facility | | $7,358.60 | $13,479.20 | $19,085.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,357.35 / $15,213.47 / $24,520.92
| Facility | | $9,357.35 | $15,213.47 | $24,520.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,650.72 / $12,125.23 / $21,572.71
| Facility | | $7,650.72 | $12,125.23 | $21,572.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $12,100.76 / $25,509.77
| Facility | | $5,264.00 | $12,100.76 | $25,509.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $11,190.92 / $22,669.32
| Facility | | $3,308.00 | $11,190.92 | $22,669.32 |