- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,921.01 / $11,565.70 / $17,631.30
| Facility | | $5,921.01 | $11,565.70 | $17,631.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,577.07 / $12,187.75 / $19,475.91
| Facility | | $7,577.07 | $12,187.75 | $19,475.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,067.94 / $7,067.94 / $7,067.94
| Facility | | $7,067.94 | $7,067.94 | $7,067.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,497.78 / $11,001.02 / $23,566.61
| Facility | | $4,497.78 | $11,001.02 | $23,566.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $10,338.46 / $20,942.52
| Facility | | $3,308.00 | $10,338.46 | $20,942.52 |