- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,584.62 / $10,482.70 / $16,878.50
| Facility | | $4,584.62 | $10,482.70 | $16,878.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,751.83 / $6,751.83 / $16,258.68
| Facility | | $6,751.83 | $6,751.83 | $16,258.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,930.56 / $14,652.63
| Facility | | $1,474.01 | $5,930.56 | $14,652.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,588.15 / $11,402.27 / $15,526.68
| Facility | | $7,588.15 | $11,402.27 | $15,526.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,632.88 / $9,192.77 / $19,305.93
| Facility | | $6,632.88 | $9,192.77 | $19,305.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,227.58 / $9,192.77 / $19,555.22
| Facility | | $6,227.58 | $9,192.77 | $19,555.22 |