- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,988.26 / $9,137.28 / $12,937.40
| Facility | | $4,988.26 | $9,137.28 | $12,937.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,795.02 / $8,044.05 / $13,387.66
| Facility | | $4,795.02 | $8,044.05 | $13,387.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,186.28 / $8,219.46 / $14,623.74
| Facility | | $5,186.28 | $8,219.46 | $14,623.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,850.42 / $7,180.45 / $17,292.59
| Facility | | $3,850.42 | $7,180.45 | $17,292.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,300.36 / $7,755.06 / $15,367.10
| Facility | | $3,300.36 | $7,755.06 | $15,367.10 |