- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,811.32 / $11,001.10 / $17,713.20
| Facility | | $4,811.32 | $11,001.10 | $17,713.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,242.69 / $15,254.83
| Facility | | $1,474.01 | $6,242.69 | $15,254.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,963.38 / $11,502.35 / $16,294.47
| Facility | | $7,963.38 | $11,502.35 | $16,294.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,960.87 / $11,770.36 / $20,260.61
| Facility | | $6,960.87 | $11,770.36 | $20,260.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,535.53 / $11,770.36 / $19,625.00
| Facility | | $6,535.53 | $11,770.36 | $19,625.00 |