- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $8,912.51 / $12,302.69
| Facility | | $4,786.30 | $8,912.51 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $7,943.28 / $13,182.57
| Facility | | $5,370.32 | $7,943.28 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $9,549.93 / $13,182.57
| Facility | | $4,677.35 | $9,549.93 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $7,079.46 / $14,125.38
| Facility | | $3,467.37 | $7,079.46 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $7,244.36 / $13,803.84
| Facility | | $3,311.31 | $7,244.36 | $13,803.84 |