- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,737.79 / $9,333.40 / $12,826.20
| Facility | | $5,737.79 | $9,333.40 | $12,826.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,069.45 / $8,069.45 / $8,675.07
| Facility | | $8,069.45 | $8,069.45 | $8,675.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,994.82 / $9,311.87 / $14,104.46
| Facility | | $5,994.82 | $9,311.87 | $14,104.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,536.48 / $8,077.69 / $12,927.71
| Facility | | $5,536.48 | $8,077.69 | $12,927.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,038.89 / $8,077.69 / $11,785.25
| Facility | | $5,038.89 | $8,077.69 | $11,785.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,237.60 / $10,403.00 / $14,256.75
| Facility | | $5,237.60 | $10,403.00 | $14,256.75 |