- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,790.20 / $8,774.49 / $12,423.70
| Facility | | $4,790.20 | $8,774.49 | $12,423.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,473.27 / $8,789.04 / $14,068.36
| Facility | | $5,473.27 | $8,789.04 | $14,068.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,980.35 / $7,893.12 / $14,043.11
| Facility | | $4,980.35 | $7,893.12 | $14,043.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,697.54 / $7,656.93 / $16,606.00
| Facility | | $3,697.54 | $7,656.93 | $16,606.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,169.32 / $7,473.00 / $14,756.96
| Facility | | $3,169.32 | $7,473.00 | $14,756.96 |