- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,414.20 / $6,437.38 / $10,449.90
| Facility | | $4,414.20 | $6,437.38 | $10,449.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,212.69 / $8,641.78 / $10,340.51
| Facility | | $7,212.69 | $8,641.78 | $10,340.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,026.15 / $12,832.01 / $16,451.30
| Facility | | $9,026.15 | $12,832.01 | $16,451.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,183.31 / $10,021.44 / $12,675.31
| Facility | | $5,183.31 | $10,021.44 | $12,675.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,605.47 / $6,922.94 / $11,070.10
| Facility | | $4,605.47 | $6,922.94 | $11,070.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,386.06 / $9,210.23 / $13,993.01
| Facility | | $5,386.06 | $9,210.23 | $13,993.01 |