- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $8,709.64 / $12,302.69
| Facility | | $5,623.41 | $8,709.64 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $6,606.93 / $10,232.93
| Facility | | $4,570.88 | $6,606.93 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $8,709.64 / $11,748.98
| Facility | | $5,248.07 | $8,709.64 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $7,079.46 / $10,964.78
| Facility | | $4,466.84 | $7,079.46 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $5,128.61 / $8,709.64
| Facility | | $3,235.94 | $5,128.61 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $8,709.64 / $11,748.98
| Facility | | $4,570.88 | $8,709.64 | $11,748.98 |