- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,777.80 / $6,967.63 / $11,310.60
| Facility | | $4,777.80 | $6,967.63 | $11,310.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,425.50 / $9,425.50 / $10,158.04
| Facility | | $9,425.50 | $9,425.50 | $10,158.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,563.99 / $16,439.93 / $21,076.85
| Facility | | $11,563.99 | $16,439.93 | $21,076.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,610.26 / $10,846.91 / $13,719.38
| Facility | | $5,610.26 | $10,846.91 | $13,719.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,984.84 / $7,493.18 / $11,981.90
| Facility | | $4,984.84 | $7,493.18 | $11,981.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,560.72 / $9,968.87 / $15,145.63
| Facility | | $6,560.72 | $9,968.87 | $15,145.63 |