- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,990.25 / $14,913.30 / $20,012.50
| Facility | | $8,990.25 | $14,913.30 | $20,012.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,773.33 / $8,854.70 / $13,142.93
| Facility | | $5,773.33 | $8,854.70 | $13,142.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,134.51 / $12,583.29 / $19,848.99
| Facility | | $7,134.51 | $12,583.29 | $19,848.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,382.21 / $12,007.50 / $27,538.00
| Facility | | $7,382.21 | $12,007.50 | $27,538.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,712.64 / $11,828.19 / $16,756.07
| Facility | | $8,712.64 | $11,828.19 | $16,756.07 |