- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $11,220.18 / $19,054.61
| Facility | | $7,585.78 | $11,220.18 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $8,912.51 / $14,791.08
| Facility | | $6,606.93 | $8,912.51 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $8,317.64 / $10,715.19
| Facility | | $5,888.44 | $8,317.64 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $9,549.93 / $13,803.84
| Facility | | $5,888.44 | $9,549.93 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $8,912.51 / $12,022.64
| Facility | | $6,606.93 | $8,912.51 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $10,232.93 / $14,125.38
| Facility | | $3,801.89 | $10,232.93 | $14,125.38 |