- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,836.60 / $7,053.38 / $11,449.80
| Facility | | $4,836.60 | $7,053.38 | $11,449.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,615.79 / $13,727.25 / $17,608.43
| Facility | | $9,615.79 | $13,727.25 | $17,608.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,679.31 / $11,074.85 / $16,087.34
| Facility | | $5,679.31 | $11,074.85 | $16,087.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,046.18 / $7,585.40 / $12,129.40
| Facility | | $5,046.18 | $7,585.40 | $12,129.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,901.46 / $10,091.57 / $15,332.02
| Facility | | $5,901.46 | $10,091.57 | $15,332.02 |