- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,623.53 / $8,536.83 / $17,349.09
| Facility | | $6,623.53 | $8,536.83 | $17,349.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,827.37 / $8,827.37 / $8,827.37
| Facility | | $8,827.37 | $8,827.37 | $8,827.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,328.94 / $7,933.46 / $9,070.00
| Facility | | $6,328.94 | $7,933.46 | $9,070.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,287.00 / $9,358.54 / $12,171.18
| Facility | | $5,287.00 | $9,358.54 | $12,171.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,151.49 / $10,151.49 / $10,151.49
| Facility | | $10,151.49 | $10,151.49 | $10,151.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $7,505.32 / $11,558.37
| Facility | | $1,286.00 | $7,505.32 | $11,558.37 |