- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,443.70 / $8,000.32 / $12,351.80
| Facility | | $5,443.70 | $8,000.32 | $12,351.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,438.17 / $10,574.47 / $13,557.01
| Facility | | $7,438.17 | $10,574.47 | $13,557.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,126.69 / $11,845.38 / $14,982.26
| Facility | | $6,126.69 | $11,845.38 | $14,982.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,443.70 / $8,182.94 / $13,084.90
| Facility | | $5,443.70 | $8,182.94 | $13,084.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,366.34 / $10,886.52 / $16,539.79
| Facility | | $6,366.34 | $10,886.52 | $16,539.79 |