- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,956.32 / $5,814.40 / $8,976.93
| Facility | | $3,956.32 | $5,814.40 | $8,976.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,928.53 / $11,271.59 / $14,450.75
| Facility | | $7,928.53 | $11,271.59 | $14,450.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,452.70 / $8,608.87 / $10,888.67
| Facility | | $4,452.70 | $8,608.87 | $10,888.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,956.32 / $5,947.12 / $9,509.70
| Facility | | $3,956.32 | $5,947.12 | $9,509.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,626.87 / $7,912.01 / $12,020.64
| Facility | | $4,626.87 | $7,912.01 | $12,020.64 |