- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $6,918.31 / $18,620.87
| Facility | | $4,365.16 | $6,918.31 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $14,791.08 / $23,442.29
| Facility | | $10,471.29 | $14,791.08 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $9,332.54 / $12,302.69
| Facility | | $5,888.44 | $9,332.54 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $26,915.35 / $26,915.35
| Facility | | $26,915.35 | $26,915.35 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $9,549.93 / $14,791.08
| Facility | | $2,951.21 | $9,549.93 | $14,791.08 |