- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,025.22 / $10,879.90 / $12,306.70
| Facility | | $7,025.22 | $10,879.90 | $12,306.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,532.67 / $9,880.46 / $13,344.32
| Facility | | $6,532.67 | $9,880.46 | $13,344.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,487.28 / $10,010.56 / $15,284.50
| Facility | | $6,487.28 | $10,010.56 | $15,284.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,487.00 / $11,745.00 / $19,082.00
| Facility | | $7,487.00 | $11,745.00 | $19,082.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $12,568.44 / $16,727.58
| Facility | | $5,274.00 | $12,568.44 | $16,727.58 |