- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,317.24 / $7,814.48 / $12,064.90
| Facility | | $5,317.24 | $7,814.48 | $12,064.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,724.14 / $12,402.67 / $15,900.86
| Facility | | $8,724.14 | $12,402.67 | $15,900.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,984.37 / $11,570.22 / $14,634.24
| Facility | | $5,984.37 | $11,570.22 | $14,634.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,317.24 / $7,992.85 / $12,780.90
| Facility | | $5,317.24 | $7,992.85 | $12,780.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,218.46 / $10,633.64 / $16,155.59
| Facility | | $6,218.46 | $10,633.64 | $16,155.59 |