- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,539.45 / $8,315.18 / $11,773.40
| Facility | | $4,539.45 | $8,315.18 | $11,773.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,147.47 / $8,405.60 / $13,718.00
| Facility | | $5,147.47 | $8,405.60 | $13,718.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,719.66 / $7,479.95 / $13,308.01
| Facility | | $4,719.66 | $7,479.95 | $13,308.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,503.99 / $7,165.63 / $15,736.75
| Facility | | $3,503.99 | $7,165.63 | $15,736.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,003.42 / $7,291.87 / $13,984.50
| Facility | | $3,003.42 | $7,291.87 | $13,984.50 |