- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,475.36 / $5,695.68 / $11,599.50
| Facility | | $5,475.36 | $5,695.68 | $11,599.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,321.50 / $10,069.58 / $13,511.20
| Facility | | $7,321.50 | $10,069.58 | $13,511.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,998.69 / $8,237.79 / $11,548.03
| Facility | | $5,998.69 | $8,237.79 | $11,548.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,222.39 / $9,148.99 / $11,533.89
| Facility | | $5,222.39 | $9,148.99 | $11,533.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,222.39 / $9,225.15 / $12,096.93
| Facility | | $5,222.39 | $9,225.15 | $12,096.93 |