- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $6,309.57 / $8,511.38
| Facility | | $2,454.71 | $6,309.57 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $6,918.31 / $8,912.51
| Facility | | $3,801.89 | $6,918.31 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $6,456.54 / $7,413.10
| Facility | | $4,786.30 | $6,456.54 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $6,606.93 / $9,332.54
| Facility | | $5,370.32 | $6,606.93 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $5,754.40 / $8,128.31
| Facility | | $1,819.70 | $5,754.40 | $8,128.31 |