- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,568.66 / $8,368.67 / $11,849.10
| Facility | | $4,568.66 | $8,368.67 | $11,849.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,124.28 / $8,307.46 / $13,148.96
| Facility | | $5,124.28 | $8,307.46 | $13,148.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,750.02 / $7,528.06 / $13,393.62
| Facility | | $4,750.02 | $7,528.06 | $13,393.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,526.53 / $7,197.81 / $15,837.98
| Facility | | $3,526.53 | $7,197.81 | $15,837.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,022.74 / $7,338.78 / $14,074.45
| Facility | | $3,022.74 | $7,338.78 | $14,074.45 |