- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,785.83 / $7,457.15 / $15,154.90
| Facility | | $5,785.83 | $7,457.15 | $15,154.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,155.37 / $9,155.37 / $9,418.99
| Facility | | $9,155.37 | $9,155.37 | $9,418.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,842.59 / $7,323.81 / $8,373.01
| Facility | | $5,842.59 | $7,323.81 | $8,373.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,618.33 / $8,174.93 / $10,631.84
| Facility | | $4,618.33 | $8,174.93 | $10,631.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,528.68 / $10,528.68 / $11,302.79
| Facility | | $10,528.68 | $10,528.68 | $11,302.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $6,556.09 / $10,096.54
| Facility | | $1,286.00 | $6,556.09 | $10,096.54 |