- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,583.64 / $8,194.00 / $13,193.40
| Facility | | $3,583.64 | $8,194.00 | $13,193.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,198.47 / $6,198.47 / $7,266.05
| Facility | | $6,198.47 | $6,198.47 | $7,266.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,280.94 / $11,608.41
| Facility | | $1,474.01 | $5,280.94 | $11,608.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,931.40 / $8,567.35 / $12,136.68
| Facility | | $5,931.40 | $8,567.35 | $12,136.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,184.68 / $7,185.67 / $20,846.33
| Facility | | $5,184.68 | $7,185.67 | $20,846.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,867.89 / $7,185.67 / $15,285.65
| Facility | | $4,867.89 | $7,185.67 | $15,285.65 |