- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,391.99 / $9,876.82 / $13,984.50
| Facility | | $5,391.99 | $9,876.82 | $13,984.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,929.29 / $11,001.04 / $17,445.18
| Facility | | $6,929.29 | $11,001.04 | $17,445.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,606.04 / $8,884.71 / $15,807.33
| Facility | | $5,606.04 | $8,884.71 | $15,807.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,162.06 / $8,382.73 / $18,692.20
| Facility | | $4,162.06 | $8,382.73 | $18,692.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $8,291.00 / $16,610.87
| Facility | | $3,308.00 | $8,291.00 | $16,610.87 |