- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $8,128.31 / $12,589.25
| Facility | | $5,754.40 | $8,128.31 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $6,918.31 / $10,715.19
| Facility | | $4,786.30 | $6,918.31 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $8,912.51 / $12,302.69
| Facility | | $5,495.41 | $8,912.51 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $7,413.10 / $11,481.54
| Facility | | $5,248.07 | $7,413.10 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $5,370.32 / $9,120.11
| Facility | | $3,388.44 | $5,370.32 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $9,120.11 / $12,589.25
| Facility | | $5,128.61 | $9,120.11 | $12,589.25 |