- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $6,309.57 / $17,782.79
| Facility | | $5,248.07 | $6,309.57 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $10,232.93 / $13,489.63
| Facility | | $7,079.46 | $10,232.93 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $8,317.64 / $11,481.54
| Facility | | $6,760.83 | $8,317.64 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,317.64 / $10,964.78
| Facility | | $5,011.87 | $8,317.64 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $7,762.47 / $11,748.98
| Facility | | $5,011.87 | $7,762.47 | $11,748.98 |