- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,458.65 / $9,998.92 / $14,157.40
| Facility | | $5,458.65 | $9,998.92 | $14,157.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,357.62 / $10,224.48 / $15,764.81
| Facility | | $6,357.62 | $10,224.48 | $15,764.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,675.34 / $8,994.54 / $16,002.74
| Facility | | $5,675.34 | $8,994.54 | $16,002.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,213.51 / $8,486.35 / $18,923.27
| Facility | | $4,213.51 | $8,486.35 | $18,923.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $8,291.00 / $16,816.20
| Facility | | $3,308.00 | $8,291.00 | $16,816.20 |