- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,502.45 / $10,079.20 / $14,271.00
| Facility | | $5,502.45 | $10,079.20 | $14,271.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,547.51 / $8,799.71 / $13,957.20
| Facility | | $5,547.51 | $8,799.71 | $13,957.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,720.88 / $9,066.73 / $16,131.15
| Facility | | $5,720.88 | $9,066.73 | $16,131.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,247.32 / $8,316.28 / $19,075.11
| Facility | | $4,247.32 | $8,316.28 | $19,075.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $8,368.09 / $16,951.14
| Facility | | $3,308.00 | $8,368.09 | $16,951.14 |