- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,154.35 / $9,498.92 / $15,294.50
| Facility | | $4,154.35 | $9,498.92 | $15,294.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,281.30 / $13,281.30 / $13,281.30
| Facility | | $13,281.30 | $13,281.30 | $13,281.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,930.56 / $13,514.02
| Facility | | $1,474.01 | $5,930.56 | $13,514.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,876.00 / $9,931.74 / $14,069.50
| Facility | | $6,876.00 | $9,931.74 | $14,069.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,010.38 / $8,330.02 / $17,494.07
| Facility | | $6,010.38 | $8,330.02 | $17,494.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,643.12 / $8,330.02 / $17,719.95
| Facility | | $5,643.12 | $8,330.02 | $17,719.95 |