- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,038.63 / $9,234.33 / $14,868.40
| Facility | | $4,038.63 | $9,234.33 | $14,868.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,671.17 / $8,671.17 / $8,671.17
| Facility | | $8,671.17 | $8,671.17 | $8,671.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,930.56 / $13,551.83
| Facility | | $1,474.01 | $5,930.56 | $13,551.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,684.47 / $9,655.09 / $13,677.59
| Facility | | $6,684.47 | $9,655.09 | $13,677.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,842.96 / $8,097.99 / $17,006.77
| Facility | | $5,842.96 | $8,097.99 | $17,006.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,485.93 / $8,097.99 / $17,226.36
| Facility | | $5,485.93 | $8,097.99 | $17,226.36 |