- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,800.35 / $8,793.09 / $12,450.10
| Facility | | $4,800.35 | $8,793.09 | $12,450.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,363.21 / $8,653.64 / $13,785.47
| Facility | | $5,363.21 | $8,653.64 | $13,785.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,990.92 / $7,909.85 / $14,072.88
| Facility | | $4,990.92 | $7,909.85 | $14,072.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,705.38 / $7,673.16 / $16,641.21
| Facility | | $3,705.38 | $7,673.16 | $16,641.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,176.04 / $7,473.00 / $14,788.25
| Facility | | $3,176.04 | $7,473.00 | $14,788.25 |