- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $7,943.28 / $9,120.11
| Facility | | $5,128.61 | $7,943.28 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $8,511.38 / $11,481.54
| Facility | | $5,754.40 | $8,511.38 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $7,762.47 / $13,803.84
| Facility | | $4,786.30 | $7,762.47 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $8,912.51 / $19,952.62
| Facility | | $6,025.60 | $8,912.51 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $8,912.51 / $12,302.69
| Facility | | $4,073.80 | $8,912.51 | $12,302.69 |