- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,554.74 / $8,448.17 / $17,168.90
| Facility | | $6,554.74 | $8,448.17 | $17,168.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,771.08 / $7,771.08 / $7,771.08
| Facility | | $7,771.08 | $7,771.08 | $7,771.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,292.02 / $7,887.18 / $9,017.09
| Facility | | $6,292.02 | $7,887.18 | $9,017.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,232.08 / $9,261.34 / $12,044.77
| Facility | | $5,232.08 | $9,261.34 | $12,044.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,936.74 / $8,936.74 / $8,936.74
| Facility | | $8,936.74 | $8,936.74 | $8,936.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $7,427.36 / $11,438.32
| Facility | | $1,286.00 | $7,427.36 | $11,438.32 |