- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,298.34 / $8,944.46 / $15,739.70
| Facility | | $5,298.34 | $8,944.46 | $15,739.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,376.12 / $9,434.37 / $15,607.06
| Facility | | $6,376.12 | $9,434.37 | $15,607.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,819.67 / $8,244.62 / $11,868.48
| Facility | | $4,819.67 | $8,244.62 | $11,868.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,666.59 / $18,666.59 / $21,906.84
| Facility | | $18,666.59 | $18,666.59 | $21,906.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $7,795.03 / $11,134.31
| Facility | | $1,787.00 | $7,795.03 | $11,134.31 |