- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,082.21 / $9,309.37 / $13,181.10
| Facility | | $5,082.21 | $9,309.37 | $13,181.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,496.42 / $9,025.21 / $14,553.14
| Facility | | $5,496.42 | $9,025.21 | $14,553.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,283.96 / $8,374.28 / $14,899.17
| Facility | | $5,283.96 | $8,374.28 | $14,899.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,922.94 / $7,890.45 / $17,618.29
| Facility | | $3,922.94 | $7,890.45 | $17,618.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $7,901.12 / $15,656.53
| Facility | | $3,308.00 | $7,901.12 | $15,656.53 |