- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,943.95 / $9,127.12 / $15,137.60
| Facility | | $5,943.95 | $9,127.12 | $15,137.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,976.00 / $8,720.71 / $9,504.00
| Facility | | $5,976.00 | $8,720.71 | $9,504.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,434.63 / $8,141.40 / $13,791.71
| Facility | | $5,434.63 | $8,141.40 | $13,791.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,859.21 / $9,725.12 / $13,983.55
| Facility | | $7,859.21 | $9,725.12 | $13,983.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,529.54 / $9,224.84 / $15,651.20
| Facility | | $6,529.54 | $9,224.84 | $15,651.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,529.54 / $9,224.84 / $13,101.29
| Facility | | $6,529.54 | $9,224.84 | $13,101.29 |