- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,339.94 / $9,781.46 / $13,849.50
| Facility | | $5,339.94 | $9,781.46 | $13,849.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,294.79 / $9,497.58 / $10,984.09
| Facility | | $9,294.79 | $9,497.58 | $10,984.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,038.30 / $9,823.14 / $15,850.93
| Facility | | $6,038.30 | $9,823.14 | $15,850.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,551.92 / $8,798.95 / $15,654.73
| Facility | | $5,551.92 | $8,798.95 | $15,654.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,121.88 / $8,429.95 / $18,511.75
| Facility | | $4,121.88 | $8,429.95 | $18,511.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $8,291.00 / $16,450.50
| Facility | | $3,308.00 | $8,291.00 | $16,450.50 |