- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,319.56 / $10,668.50 / $18,773.40
| Facility | | $6,319.56 | $10,668.50 | $18,773.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,203.99 / $10,203.99 / $10,203.99
| Facility | | $10,203.99 | $10,203.99 | $10,203.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,104.19 / $8,958.27 / $14,776.50
| Facility | | $6,104.19 | $8,958.27 | $14,776.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,748.63 / $9,833.71 / $14,156.06
| Facility | | $5,748.63 | $9,833.71 | $14,156.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,880.30 / $19,880.30 / $23,331.22
| Facility | | $19,880.30 | $19,880.30 | $23,331.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $9,297.48 / $13,280.38
| Facility | | $1,787.00 | $9,297.48 | $13,280.38 |