- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,864.67 / $8,018.72 / $10,756.40
| Facility | | $3,864.67 | $8,018.72 | $10,756.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,494.88 / $5,494.88 / $8,146.65
| Facility | | $5,494.88 | $5,494.88 | $8,146.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $7,285.85 / $8,663.21
| Facility | | $2,651.00 | $7,285.85 | $8,663.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,815.91 / $8,280.20 / $13,032.78
| Facility | | $6,815.91 | $8,280.20 | $13,032.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,475.45 / $10,229.96
| Facility | | $1,350.00 | $5,475.45 | $10,229.96 |