- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $12,022.64 / $15,488.17
| Facility | | $8,128.31 | $12,022.64 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $5,128.61 / $10,964.78
| Facility | | $2,754.23 | $5,128.61 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $5,888.44 / $10,964.78
| Facility | | $4,265.80 | $5,888.44 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $5,888.44 / $10,964.78
| Facility | | $4,265.80 | $5,888.44 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $7,413.10 / $12,022.64
| Facility | | $3,162.28 | $7,413.10 | $12,022.64 |