- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,308.20 / $9,723.33 / $13,767.20
| Facility | | $5,308.20 | $9,723.33 | $13,767.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,761.02 / $9,339.75 / $14,782.84
| Facility | | $5,761.02 | $9,339.75 | $14,782.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,518.92 / $8,746.65 / $15,561.68
| Facility | | $5,518.92 | $8,746.65 | $15,561.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,097.38 / $7,899.24 / $18,401.72
| Facility | | $4,097.38 | $7,899.24 | $18,401.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $8,252.45 / $16,352.73
| Facility | | $3,308.00 | $8,252.45 | $16,352.73 |