- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,636.71 / $8,060.99 / $13,383.20
| Facility | | $5,636.71 | $8,060.99 | $13,383.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,387.41 / $7,387.41 / $7,387.41
| Facility | | $7,387.41 | $7,387.41 | $7,387.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,676.54 / $7,005.73 / $11,867.86
| Facility | | $4,676.54 | $7,005.73 | $11,867.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,922.00 / $8,597.98 / $12,362.84
| Facility | | $6,922.00 | $8,597.98 | $12,362.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,319.38 / $8,667.09 / $20,911.64
| Facility | | $4,319.38 | $8,667.09 | $20,911.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,319.38 / $8,241.37 / $11,582.84
| Facility | | $4,319.38 | $8,241.37 | $11,582.84 |