- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,742.08 / $5,973.14 / $12,164.60
| Facility | | $5,742.08 | $5,973.14 | $12,164.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,678.15 / $10,560.10 / $14,169.37
| Facility | | $7,678.15 | $10,560.10 | $14,169.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,290.90 / $8,639.08 / $12,110.57
| Facility | | $6,290.90 | $8,639.08 | $12,110.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,476.80 / $9,594.67 / $12,095.74
| Facility | | $5,476.80 | $9,594.67 | $12,095.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,476.80 / $9,674.54 / $12,686.21
| Facility | | $5,476.80 | $9,674.54 | $12,686.21 |