- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,314.74 / $7,810.80 / $12,059.20
| Facility | | $5,314.74 | $7,810.80 | $12,059.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,821.76 / $13,963.10 / $17,901.41
| Facility | | $9,821.76 | $13,963.10 | $17,901.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,981.55 / $11,564.77 / $14,627.34
| Facility | | $5,981.55 | $11,564.77 | $14,627.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,314.74 / $7,989.09 / $12,774.90
| Facility | | $5,314.74 | $7,989.09 | $12,774.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,215.53 / $10,628.63 / $16,147.98
| Facility | | $6,215.53 | $10,628.63 | $16,147.98 |