- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,889.96 / $5,716.88 / $8,826.37
| Facility | | $3,889.96 | $5,716.88 | $8,826.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,048.63 / $9,024.37 / $11,164.15
| Facility | | $8,048.63 | $9,024.37 | $11,164.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,946.39 / $11,296.97 / $14,483.30
| Facility | | $7,946.39 | $11,296.97 | $14,483.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,378.02 / $8,464.49 / $10,706.04
| Facility | | $4,378.02 | $8,464.49 | $10,706.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,889.96 / $5,847.37 / $9,350.20
| Facility | | $3,889.96 | $5,847.37 | $9,350.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,549.27 / $7,779.31 / $11,819.03
| Facility | | $4,549.27 | $7,779.31 | $11,819.03 |