- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,635.12 / $10,322.20 / $14,615.10
| Facility | | $5,635.12 | $10,322.20 | $14,615.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,138.56 / $9,873.89 / $15,778.39
| Facility | | $6,138.56 | $9,873.89 | $15,778.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,858.82 / $9,285.34 / $16,520.09
| Facility | | $5,858.82 | $9,285.34 | $16,520.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,349.72 / $8,700.65 / $19,535.05
| Facility | | $4,349.72 | $8,700.65 | $19,535.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $8,569.86 / $17,359.86
| Facility | | $3,308.00 | $8,569.86 | $17,359.86 |