- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $6,025.60 / $7,762.47
| Facility | | $5,370.32 | $6,025.60 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $6,309.57 / $12,882.50
| Facility | | $2,691.53 | $6,309.57 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $7,244.36 / $10,715.19
| Facility | | $5,623.41 | $7,244.36 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $6,918.31 / $11,220.18
| Facility | | $3,981.07 | $6,918.31 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $6,760.83 / $9,549.93
| Facility | | $4,466.84 | $6,760.83 | $9,549.93 |