- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $12,882.50 / $31,622.78
| Facility | | $5,623.41 | $12,882.50 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $5,888.44 / $17,782.79
| Facility | | $5,888.44 | $5,888.44 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $15,135.61 / $23,988.33
| Facility | | $9,549.93 | $15,135.61 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $13,803.84 / $23,988.33
| Facility | | $8,128.31 | $13,803.84 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $10,471.29 / $21,877.62
| Facility | | $7,244.36 | $10,471.29 | $21,877.62 |