- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,362.60 / $11,654.70 / $16,501.90
| Facility | | $6,362.60 | $11,654.70 | $16,501.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,062.05 / $11,448.98 / $18,121.31
| Facility | | $7,062.05 | $11,448.98 | $18,121.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,615.18 / $10,484.06 / $18,652.80
| Facility | | $6,615.18 | $10,484.06 | $18,652.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,911.27 / $9,954.84 / $22,056.97
| Facility | | $4,911.27 | $9,954.84 | $22,056.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $9,676.20 / $19,600.98
| Facility | | $3,308.00 | $9,676.20 | $19,600.98 |