- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,844.39 / $7,064.75 / $11,468.30
| Facility | | $4,844.39 | $7,064.75 | $11,468.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,190.34 / $14,487.09 / $18,573.18
| Facility | | $10,190.34 | $14,487.09 | $18,573.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,688.46 / $10,998.11 / $13,910.62
| Facility | | $5,688.46 | $10,998.11 | $13,910.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,054.32 / $7,597.63 / $12,148.90
| Facility | | $5,054.32 | $7,597.63 | $12,148.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,910.98 / $10,107.84 / $15,356.75
| Facility | | $5,910.98 | $10,107.84 | $15,356.75 |