- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $6,456.54 / $17,782.79
| Facility | | $4,168.69 | $6,456.54 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $12,302.69 / $19,054.61
| Facility | | $8,511.38 | $12,302.69 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $8,709.64 / $11,748.98
| Facility | | $5,623.41 | $8,709.64 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $25,703.96 / $25,703.96
| Facility | | $25,703.96 | $25,703.96 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $9,120.11 / $13,803.84
| Facility | | $2,951.21 | $9,120.11 | $13,803.84 |