- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,526.33 / $8,121.76 / $12,539.30
| Facility | | $5,526.33 | $8,121.76 | $12,539.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,611.20 / $10,640.74 / $13,414.16
| Facility | | $8,611.20 | $10,640.74 | $13,414.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,964.25 / $11,322.37 / $14,515.86
| Facility | | $7,964.25 | $11,322.37 | $14,515.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,219.69 / $12,025.18 / $15,209.68
| Facility | | $6,219.69 | $12,025.18 | $15,209.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,526.33 / $8,307.15 / $13,283.50
| Facility | | $5,526.33 | $8,307.15 | $13,283.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,273.39 / $11,051.77 / $16,790.86
| Facility | | $7,273.39 | $11,051.77 | $16,790.86 |