- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,218.37 / $14,218.30 / $22,893.30
| Facility | | $6,218.37 | $14,218.30 | $22,893.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,324.41 / $10,324.41 / $10,324.41
| Facility | | $10,324.41 | $10,324.41 | $10,324.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,899.40 / $20,162.41
| Facility | | $1,474.01 | $6,899.40 | $20,162.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,292.23 / $14,866.17 / $21,059.71
| Facility | | $10,292.23 | $14,866.17 | $21,059.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,996.54 / $12,468.66 / $26,185.73
| Facility | | $8,996.54 | $12,468.66 | $26,185.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,446.82 / $12,468.66 / $26,523.84
| Facility | | $8,446.82 | $12,468.66 | $26,523.84 |