- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $10,232.93 / $12,882.50
| Facility | | $7,244.36 | $10,232.93 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $8,912.51 / $12,302.69
| Facility | | $6,025.60 | $8,912.51 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $10,471.29 / $14,791.08
| Facility | | $5,623.41 | $10,471.29 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $9,772.37 / $12,302.69
| Facility | | $6,025.60 | $9,772.37 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $10,471.29 / $14,791.08
| Facility | | $5,623.41 | $10,471.29 | $14,791.08 |