- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $5,888.44 / $15,848.93
| Facility | | $3,715.35 | $5,888.44 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $8,317.64 / $8,317.64
| Facility | | $8,317.64 | $8,317.64 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $6,760.83 / $10,232.93
| Facility | | $4,677.35 | $6,760.83 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $7,943.28 / $10,471.29
| Facility | | $5,011.87 | $7,943.28 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $22,908.68 / $22,908.68
| Facility | | $22,908.68 | $22,908.68 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $8,128.31 / $12,589.25
| Facility | | $2,951.21 | $8,128.31 | $12,589.25 |