- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,793.38 / $8,780.29 / $12,432.00
| Facility | | $4,793.38 | $8,780.29 | $12,432.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,335.30 / $8,385.12 / $9,786.71
| Facility | | $5,335.30 | $8,385.12 | $9,786.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,004.08 / $8,024.63 / $12,621.70
| Facility | | $5,004.08 | $8,024.63 | $12,621.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,983.66 / $7,555.53 / $14,052.41
| Facility | | $4,983.66 | $7,555.53 | $14,052.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,699.99 / $7,493.28 / $16,617.00
| Facility | | $3,699.99 | $7,493.28 | $16,617.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,171.42 / $7,473.00 / $14,766.74
| Facility | | $3,171.42 | $7,473.00 | $14,766.74 |