- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,971.83 / $9,081.59 / $14,622.50
| Facility | | $3,971.83 | $9,081.59 | $14,622.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,829.87 / $6,829.87 / $7,979.98
| Facility | | $6,829.87 | $6,829.87 | $7,979.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,613.58 / $12,765.68
| Facility | | $1,474.01 | $5,613.58 | $12,765.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,573.90 / $9,878.21 / $13,910.11
| Facility | | $6,573.90 | $9,878.21 | $13,910.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,746.31 / $7,964.04 / $16,725.47
| Facility | | $5,746.31 | $7,964.04 | $16,725.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,395.19 / $7,964.04 / $16,941.41
| Facility | | $5,395.19 | $7,964.04 | $16,941.41 |