- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,070.78 / $9,288.45 / $13,151.40
| Facility | | $5,070.78 | $9,288.45 | $13,151.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,401.29 / $8,679.23 / $13,638.58
| Facility | | $5,401.29 | $8,679.23 | $13,638.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,272.08 / $8,355.45 / $14,865.67
| Facility | | $5,272.08 | $8,355.45 | $14,865.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,914.12 / $7,896.00 / $17,578.68
| Facility | | $3,914.12 | $7,896.00 | $17,578.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $7,711.62 / $15,621.33
| Facility | | $3,308.00 | $7,711.62 | $15,621.33 |