- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,785.12 / $8,765.19 / $12,410.60
| Facility | | $4,785.12 | $8,765.19 | $12,410.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,721.83 / $9,337.39 / $15,248.64
| Facility | | $5,721.83 | $9,337.39 | $15,248.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,975.08 / $7,884.75 / $14,028.22
| Facility | | $4,975.08 | $7,884.75 | $14,028.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,693.62 / $7,879.43 / $16,588.39
| Facility | | $3,693.62 | $7,879.43 | $16,588.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,165.96 / $7,473.00 / $14,741.31
| Facility | | $3,165.96 | $7,473.00 | $14,741.31 |