- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,451.83 / $8,012.28 / $12,370.30
| Facility | | $5,451.83 | $8,012.28 | $12,370.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,932.40 / $10,581.69 / $16,179.25
| Facility | | $8,932.40 | $10,581.69 | $16,179.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,209.43 / $11,670.93 / $14,962.73
| Facility | | $8,209.43 | $11,670.93 | $14,962.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,135.85 / $11,863.09 / $15,004.66
| Facility | | $6,135.85 | $11,863.09 | $15,004.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,451.83 / $8,195.17 / $13,104.40
| Facility | | $5,451.83 | $8,195.17 | $13,104.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,375.86 / $10,902.80 / $16,564.52
| Facility | | $6,375.86 | $10,902.80 | $16,564.52 |