- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,948.89 / $9,065.19 / $12,835.30
| Facility | | $4,948.89 | $9,065.19 | $12,835.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,003.42 / $10,084.48 / $12,240.73
| Facility | | $10,003.42 | $10,084.48 | $12,240.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,356.86 / $8,616.54 / $13,857.23
| Facility | | $5,356.86 | $8,616.54 | $13,857.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,145.35 / $8,154.62 / $14,508.36
| Facility | | $5,145.35 | $8,154.62 | $14,508.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,820.04 / $7,896.00 / $17,156.16
| Facility | | $3,820.04 | $7,896.00 | $17,156.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,274.32 / $7,693.87 / $15,245.86
| Facility | | $3,274.32 | $7,693.87 | $15,245.86 |