- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,365.45 / $7,885.32 / $12,174.20
| Facility | | $5,365.45 | $7,885.32 | $12,174.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,567.95 / $10,731.61 / $17,552.89
| Facility | | $8,567.95 | $10,731.61 | $17,552.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,903.97 / $9,815.03 / $12,583.37
| Facility | | $6,903.97 | $9,815.03 | $12,583.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,038.62 / $11,675.11 / $14,766.90
| Facility | | $6,038.62 | $11,675.11 | $14,766.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,365.45 / $8,065.31 / $12,896.80
| Facility | | $5,365.45 | $8,065.31 | $12,896.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,274.83 / $10,730.03 / $16,302.04
| Facility | | $6,274.83 | $10,730.03 | $16,302.04 |