- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,214.22 / $6,193.44 / $9,562.12
| Facility | | $4,214.22 | $6,193.44 | $9,562.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,667.61 / $8,774.34 / $9,059.08
| Facility | | $6,667.61 | $8,774.34 | $9,059.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,969.32 / $12,751.23 / $16,347.73
| Facility | | $8,969.32 | $12,751.23 | $16,347.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,742.97 / $9,170.09 / $11,598.50
| Facility | | $4,742.97 | $9,170.09 | $11,598.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,214.22 / $6,334.81 / $10,129.60
| Facility | | $4,214.22 | $6,334.81 | $10,129.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,928.50 / $8,427.79 / $12,804.26
| Facility | | $4,928.50 | $8,427.79 | $12,804.26 |