- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,076.57 / $9,338.20 / $15,503.60
| Facility | | $7,076.57 | $9,338.20 | $15,503.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,211.38 / $7,977.79 / $13,225.14
| Facility | | $5,211.38 | $7,977.79 | $13,225.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,049.23 / $9,960.26 / $14,321.65
| Facility | | $8,049.23 | $9,960.26 | $14,321.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,003.75 / $9,999.49 / $23,303.23
| Facility | | $5,003.75 | $9,999.49 | $23,303.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,003.75 / $9,547.16 / $13,418.06
| Facility | | $5,003.75 | $9,547.16 | $13,418.06 |