- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,526.57 / $10,123.29 / $14,333.60
| Facility | | $5,526.57 | $10,123.29 | $14,333.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,002.97 / $11,404.32 / $18,402.38
| Facility | | $7,002.97 | $11,404.32 | $18,402.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,745.96 / $9,106.48 / $16,201.87
| Facility | | $5,745.96 | $9,106.48 | $16,201.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.93 / $8,632.82 / $19,158.74
| Facility | | $4,265.93 | $8,632.82 | $19,158.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $8,404.77 / $17,025.45
| Facility | | $3,308.00 | $8,404.77 | $17,025.45 |