- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,843.79 / $6,843.79 / $8,111.25
| Facility | | $6,843.79 | $6,843.79 | $8,111.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,813.20 / $7,831.34 / $11,715.20
| Facility | | $4,813.20 | $7,831.34 | $11,715.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,597.38 / $6,927.94 / $11,787.09
| Facility | | $5,597.38 | $6,927.94 | $11,787.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,007.88 / $8,035.15 / $13,152.39
| Facility | | $5,007.88 | $8,035.15 | $13,152.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.80 / $4,468.68 / $6,711.36
| Facility | | $70.80 | $4,468.68 | $6,711.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,698.72 / $7,938.39 / $9,329.60
| Facility | | $5,698.72 | $7,938.39 | $9,329.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,143.09 / $8,467.45 / $10,673.92
| Facility | | $5,143.09 | $8,467.45 | $10,673.92 |