- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,884.14 / $8,946.58 / $12,667.40
| Facility | | $4,884.14 | $8,946.58 | $12,667.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,023.26 / $8,949.78 / $15,277.51
| Facility | | $5,023.26 | $8,949.78 | $15,277.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,078.04 / $8,047.92 / $14,318.53
| Facility | | $5,078.04 | $8,047.92 | $14,318.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,770.06 / $7,907.82 / $16,931.68
| Facility | | $3,770.06 | $7,907.82 | $16,931.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,231.48 / $7,593.21 / $15,046.39
| Facility | | $3,231.48 | $7,593.21 | $15,046.39 |