- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,015.58 / $11,333.50 / $15,682.60
| Facility | | $7,015.58 | $11,333.50 | $15,682.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,525.19 / $8,991.15 / $10,983.97
| Facility | | $8,525.19 | $8,991.15 | $10,983.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,543.50 / $10,366.62 / $15,705.67
| Facility | | $6,543.50 | $10,366.62 | $15,705.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,564.00 / $9,481.92 / $15,806.67
| Facility | | $6,564.00 | $9,481.92 | $15,806.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,564.00 / $9,481.92 / $14,409.80
| Facility | | $6,564.00 | $9,481.92 | $14,409.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,404.00 / $12,202.02 / $17,431.68
| Facility | | $6,404.00 | $12,202.02 | $17,431.68 |