- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,596.14 / $5,821.32 / $11,855.40
| Facility | | $5,596.14 | $5,821.32 | $11,855.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,483.00 / $10,291.70 / $13,809.24
| Facility | | $7,483.00 | $10,291.70 | $13,809.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,131.01 / $8,419.51 / $11,802.77
| Facility | | $6,131.01 | $8,419.51 | $11,802.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,337.60 / $9,350.81 / $11,788.31
| Facility | | $5,337.60 | $9,350.81 | $11,788.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,337.60 / $9,428.65 / $12,363.77
| Facility | | $5,337.60 | $9,428.65 | $12,363.77 |