- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,736.38 / $7,393.42 / $15,025.40
| Facility | | $5,736.38 | $7,393.42 | $15,025.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,197.08 / $7,428.56 / $8,509.89
| Facility | | $6,197.08 | $7,428.56 | $8,509.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,687.10 / $7,128.90 / $8,150.18
| Facility | | $5,687.10 | $7,128.90 | $8,150.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,578.85 / $8,105.06 / $10,540.98
| Facility | | $4,578.85 | $8,105.06 | $10,540.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,126.64 / $8,542.84 / $10,532.39
| Facility | | $7,126.64 | $8,542.84 | $10,532.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $6,500.06 / $10,010.25
| Facility | | $1,286.00 | $6,500.06 | $10,010.25 |