- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,646.09 / $8,762.03 / $14,026.70
| Facility | | $5,646.09 | $8,762.03 | $14,026.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,505.89 / $7,606.24 / $7,734.13
| Facility | | $5,505.89 | $7,606.24 | $7,734.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,576.00 / $6,956.51 / $9,872.08
| Facility | | $3,576.00 | $6,956.51 | $9,872.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,217.37 / $6,989.74 / $12,246.96
| Facility | | $5,217.37 | $6,989.74 | $12,246.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,123.04 / $7,915.95 / $10,607.61
| Facility | | $5,123.04 | $7,915.95 | $10,607.61 |