- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,052.15 / $10,666.20 / $18,661.80
| Facility | | $8,052.15 | $10,666.20 | $18,661.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,445.59 / $8,748.62 / $13,155.87
| Facility | | $5,445.59 | $8,748.62 | $13,155.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,729.61 / $9,694.17 / $18,278.89
| Facility | | $5,729.61 | $9,694.17 | $18,278.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,723.62 / $11,464.60 / $17,470.00
| Facility | | $7,723.62 | $11,464.60 | $17,470.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $10,992.01 / $16,788.93
| Facility | | $3,496.00 | $10,992.01 | $16,788.93 |