- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,078.88 / $10,262.20 / $18,058.40
| Facility | | $6,078.88 | $10,262.20 | $18,058.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,710.14 / $9,904.83 / $16,424.66
| Facility | | $6,710.14 | $9,904.83 | $16,424.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,529.69 / $9,459.20 / $13,616.93
| Facility | | $5,529.69 | $9,459.20 | $13,616.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,223.09 / $19,223.09 / $22,559.94
| Facility | | $19,223.09 | $19,223.09 | $22,559.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,158.00 / $9,146.00 / $14,958.98
| Facility | | $3,158.00 | $9,146.00 | $14,958.98 |