- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,238.37 / $9,595.43 / $13,586.10
| Facility | | $5,238.37 | $9,595.43 | $13,586.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,788.81 / $11,006.68 / $17,435.84
| Facility | | $6,788.81 | $11,006.68 | $17,435.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,446.32 / $8,631.59 / $15,356.97
| Facility | | $5,446.32 | $8,631.59 | $15,356.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,043.48 / $8,614.28 / $18,159.65
| Facility | | $4,043.48 | $8,614.28 | $18,159.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,465.84 / $8,373.29 / $16,763.14
| Facility | | $3,465.84 | $8,373.29 | $16,763.14 |