- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,066.96 / $11,585.60 / $18,654.30
| Facility | | $5,066.96 | $11,585.60 | $18,654.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,939.65 / $6,939.65 / $6,939.65
| Facility | | $6,939.65 | $6,939.65 | $6,939.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,215.53 / $16,414.00
| Facility | | $1,474.01 | $6,215.53 | $16,414.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,386.49 / $12,519.10 / $17,160.23
| Facility | | $8,386.49 | $12,519.10 | $17,160.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,330.71 / $10,159.93 / $21,337.10
| Facility | | $7,330.71 | $10,159.93 | $21,337.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,882.78 / $10,159.93 / $21,612.60
| Facility | | $6,882.78 | $10,159.93 | $21,612.60 |