- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,434.18 / $10,138.79 / $16,324.70
| Facility | | $4,434.18 | $10,138.79 | $16,324.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,392.74 / $13,392.74 / $13,392.74
| Facility | | $13,392.74 | $13,392.74 | $13,392.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,254.35 / $14,406.58
| Facility | | $1,474.01 | $6,254.35 | $14,406.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,339.16 / $10,600.73 / $15,017.20
| Facility | | $7,339.16 | $10,600.73 | $15,017.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,415.23 / $8,891.12 / $19,295.00
| Facility | | $6,415.23 | $8,891.12 | $19,295.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,023.24 / $8,891.12 / $18,913.55
| Facility | | $6,023.24 | $8,891.12 | $18,913.55 |