- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $9,120.11 / $11,748.98
| Facility | | $6,606.93 | $9,120.11 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $8,128.31 / $11,220.18
| Facility | | $5,623.41 | $8,128.31 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $9,549.93 / $13,489.63
| Facility | | $5,011.87 | $9,549.93 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $8,912.51 / $10,964.78
| Facility | | $6,456.54 | $8,912.51 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $9,549.93 / $13,489.63
| Facility | | $5,128.61 | $9,549.93 | $13,489.63 |