- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,970.29 / $10,936.10 / $15,484.40
| Facility | | $5,970.29 | $10,936.10 | $15,484.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,703.46 / $10,811.47 / $17,612.98
| Facility | | $6,703.46 | $10,811.47 | $17,612.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,207.30 / $9,837.62 / $17,502.71
| Facility | | $6,207.30 | $9,837.62 | $17,502.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,608.45 / $9,144.50 / $20,696.98
| Facility | | $4,608.45 | $9,144.50 | $20,696.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $9,079.59 / $18,392.41
| Facility | | $3,308.00 | $9,079.59 | $18,392.41 |