- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,877.17 / $8,933.79 / $12,649.30
| Facility | | $4,877.17 | $8,933.79 | $12,649.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,275.55 / $8,511.06 / $13,397.40
| Facility | | $5,275.55 | $8,511.06 | $13,397.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,070.78 / $8,036.42 / $14,298.06
| Facility | | $5,070.78 | $8,036.42 | $14,298.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,764.67 / $7,611.65 / $16,907.49
| Facility | | $3,764.67 | $7,611.65 | $16,907.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,226.86 / $7,582.35 / $15,024.87
| Facility | | $3,226.86 | $7,582.35 | $15,024.87 |