- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $10,471.29 / $18,197.01
| Facility | | $7,585.78 | $10,471.29 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $9,332.54 / $14,791.08
| Facility | | $5,888.44 | $9,332.54 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $9,332.54 / $16,218.10
| Facility | | $6,456.54 | $9,332.54 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.79 / $102.33 / $158.49
| Facility | | $70.79 | $102.33 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $10,000.00 / $14,791.08
| Facility | | $6,760.83 | $10,000.00 | $14,791.08 |