- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,017.04 / $10,157.79 / $17,874.70
| Facility | | $6,017.04 | $10,157.79 | $17,874.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,045.16 / $6,289.13 / $10,868.11
| Facility | | $5,045.16 | $6,289.13 | $10,868.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,738.93 / $5,519.03 / $9,063.40
| Facility | | $3,738.93 | $5,519.03 | $9,063.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,473.44 / $9,362.96 / $13,478.40
| Facility | | $5,473.44 | $9,362.96 | $13,478.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,905.09 / $18,905.09 / $22,186.74
| Facility | | $18,905.09 | $18,905.09 | $22,186.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $9,609.00 / $12,644.64
| Facility | | $2,520.00 | $9,609.00 | $12,644.64 |