- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,158.47 / $11,794.90 / $18,991.30
| Facility | | $5,158.47 | $11,794.90 | $18,991.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,197.86 / $12,197.86 / $12,197.86
| Facility | | $12,197.86 | $12,197.86 | $12,197.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,756.22 / $16,693.98
| Facility | | $1,474.01 | $6,756.22 | $16,693.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,537.96 / $12,332.30 / $17,470.18
| Facility | | $8,537.96 | $12,332.30 | $17,470.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,463.13 / $10,343.44 / $21,722.51
| Facility | | $7,463.13 | $10,343.44 | $21,722.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,007.10 / $10,343.44 / $22,002.99
| Facility | | $7,007.10 | $10,343.44 | $22,002.99 |