- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,659.43 / $8,534.95 / $12,084.60
| Facility | | $4,659.43 | $8,534.95 | $12,084.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,163.55 / $8,305.60 / $13,272.27
| Facility | | $5,163.55 | $8,305.60 | $13,272.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,844.39 / $7,677.64 / $13,659.74
| Facility | | $4,844.39 | $7,677.64 | $13,659.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,596.60 / $7,447.90 / $16,152.67
| Facility | | $3,596.60 | $7,447.90 | $16,152.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,082.80 / $7,473.00 / $14,354.10
| Facility | | $3,082.80 | $7,473.00 | $14,354.10 |