- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,357.76 / $10,546.40 / $14,152.50
| Facility | | $6,357.76 | $10,546.40 | $14,152.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,737.49 / $7,549.20 / $9,854.60
| Facility | | $5,737.49 | $7,549.20 | $9,854.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,075.22 / $8,909.46 / $13,977.98
| Facility | | $5,075.22 | $8,909.46 | $13,977.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,220.57 / $8,491.50 / $19,474.41
| Facility | | $5,220.57 | $8,491.50 | $19,474.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,161.43 / $8,364.69 / $11,995.66
| Facility | | $6,161.43 | $8,364.69 | $11,995.66 |