- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,078.10 / $7,463.04 / $11,522.30
| Facility | | $5,078.10 | $7,463.04 | $11,522.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,996.52 / $9,946.60 / $12,752.05
| Facility | | $6,996.52 | $9,946.60 | $12,752.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,715.24 / $11,049.87 / $13,976.09
| Facility | | $5,715.24 | $11,049.87 | $13,976.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,078.10 / $7,633.39 / $12,206.10
| Facility | | $5,078.10 | $7,633.39 | $12,206.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,938.80 / $10,155.41 / $15,429.02
| Facility | | $5,938.80 | $10,155.41 | $15,429.02 |