- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $6,606.93 / $10,715.19
| Facility | | $4,677.35 | $6,606.93 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $4,897.79 / $8,317.64
| Facility | | $2,454.71 | $4,897.79 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $6,918.31 / $12,882.50
| Facility | | $4,073.80 | $6,918.31 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $18,620.87 / $18,620.87
| Facility | | $16,218.10 | $18,620.87 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $6,309.57 / $10,715.19
| Facility | | $2,511.89 | $6,309.57 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $5,888.44 / $14,454.40
| Facility | | $4,073.80 | $5,888.44 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $5,623.41 / $12,589.25
| Facility | | $2,511.89 | $5,623.41 | $12,589.25 |