- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $7,585.78 / $10,964.78
| Facility | | $4,786.30 | $7,585.78 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $11,481.54 / $17,378.01
| Facility | | $10,471.29 | $11,481.54 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $8,912.51 / $12,022.64
| Facility | | $5,754.40 | $8,912.51 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $7,762.47 / $12,302.69
| Facility | | $4,897.79 | $7,762.47 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $5,754.40 / $12,022.64
| Facility | | $2,187.76 | $5,754.40 | $12,022.64 |