- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,893.43 / $7,191.64 / $11,103.30
| Facility | | $4,893.43 | $7,191.64 | $11,103.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,848.48 / $9,848.48 / $11,512.17
| Facility | | $9,848.48 | $9,848.48 | $11,512.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,211.04 / $11,673.24 / $14,965.69
| Facility | | $8,211.04 | $11,673.24 | $14,965.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,507.40 / $10,648.04 / $13,467.84
| Facility | | $5,507.40 | $10,648.04 | $13,467.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,893.43 / $7,355.80 / $11,762.20
| Facility | | $4,893.43 | $7,355.80 | $11,762.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,722.83 / $9,345.21 / $14,696.74
| Facility | | $5,722.83 | $9,345.21 | $14,696.74 |