- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,599.19 / $9,452.36 / $16,633.40
| Facility | | $5,599.19 | $9,452.36 | $16,633.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,112.69 / $4,402.72 / $7,113.37
| Facility | | $3,112.69 | $4,402.72 | $7,113.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,093.34 / $8,712.77 / $12,542.40
| Facility | | $5,093.34 | $8,712.77 | $12,542.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,459.90 / $18,459.90 / $21,664.26
| Facility | | $18,459.90 | $18,459.90 | $21,664.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $8,237.65 / $11,766.54
| Facility | | $1,787.00 | $8,237.65 | $11,766.54 |