- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,590.24 / $8,408.20 / $11,905.10
| Facility | | $4,590.24 | $8,408.20 | $11,905.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,190.22 / $8,522.45 / $13,742.42
| Facility | | $5,190.22 | $8,522.45 | $13,742.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,772.46 / $9,660.62 / $14,495.00
| Facility | | $4,772.46 | $9,660.62 | $14,495.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,543.19 / $7,136.27 / $15,912.80
| Facility | | $3,543.19 | $7,136.27 | $15,912.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,037.02 / $7,337.30 / $14,689.08
| Facility | | $3,037.02 | $7,337.30 | $14,689.08 |