- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,245.89 / $8,050.10 / $16,359.90
| Facility | | $6,245.89 | $8,050.10 | $16,359.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,777.43 / $8,773.53 / $10,030.32
| Facility | | $5,777.43 | $8,773.53 | $10,030.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,130.85 / $7,685.15 / $8,786.11
| Facility | | $6,130.85 | $7,685.15 | $8,786.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,985.55 / $8,824.95 / $11,477.23
| Facility | | $4,985.55 | $8,824.95 | $11,477.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,331.49 / $10,265.00 / $12,036.38
| Facility | | $6,331.49 | $10,265.00 | $12,036.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $7,657.01 / $10,899.36
| Facility | | $1,286.00 | $7,657.01 | $10,899.36 |