- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $10,232.93 / $13,803.84
| Facility | | $5,370.32 | $10,232.93 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $8,128.31 / $13,182.57
| Facility | | $5,370.32 | $8,128.31 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $10,964.78 / $14,791.08
| Facility | | $5,248.07 | $10,964.78 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $7,943.28 / $16,218.10
| Facility | | $3,890.45 | $7,943.28 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $8,128.31 / $15,488.17
| Facility | | $3,388.44 | $8,128.31 | $15,488.17 |