- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,103.16 / $9,347.75 / $13,235.40
| Facility | | $5,103.16 | $9,347.75 | $13,235.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,435.65 / $8,769.34 / $13,801.79
| Facility | | $5,435.65 | $8,769.34 | $13,801.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,305.74 / $8,408.79 / $14,960.58
| Facility | | $5,305.74 | $8,408.79 | $14,960.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,939.11 / $7,941.51 / $17,690.91
| Facility | | $3,939.11 | $7,941.51 | $17,690.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,939.11 / $8,403.12 / $17,690.91
| Facility | | $3,939.11 | $8,403.12 | $17,690.91 |