- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,225.67 / $9,572.17 / $13,553.20
| Facility | | $5,225.67 | $9,572.17 | $13,553.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,792.12 / $9,180.54 / $14,572.63
| Facility | | $5,792.12 | $9,180.54 | $14,572.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,433.12 / $8,610.67 / $15,319.75
| Facility | | $5,433.12 | $8,610.67 | $15,319.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,033.68 / $8,306.27 / $18,115.64
| Facility | | $4,033.68 | $8,306.27 | $18,115.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $8,124.16 / $16,098.50
| Facility | | $3,308.00 | $8,124.16 | $16,098.50 |