- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,067.47 / $7,447.40 / $11,498.10
| Facility | | $5,067.47 | $7,447.40 | $11,498.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,851.14 / $9,813.69 / $15,091.95
| Facility | | $7,851.14 | $9,813.69 | $15,091.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,499.87 / $10,662.19 / $13,669.47
| Facility | | $7,499.87 | $10,662.19 | $13,669.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,703.26 / $11,026.72 / $13,946.80
| Facility | | $5,703.26 | $11,026.72 | $13,946.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,067.47 / $7,617.40 / $12,180.50
| Facility | | $5,067.47 | $7,617.40 | $12,180.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,926.35 / $10,134.12 / $15,396.69
| Facility | | $5,926.35 | $10,134.12 | $15,396.69 |