- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,533.73 / $9,481.92 / $9,481.92
| Facility | | $8,533.73 | $9,481.92 | $9,481.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,327.42 / $6,327.42 / $9,278.19
| Facility | | $6,327.42 | $6,327.42 | $9,278.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,907.09 / $7,993.85 / $17,520.11
| Facility | | $4,907.09 | $7,993.85 | $17,520.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,837.95 / $10,704.29 / $16,407.04
| Facility | | $7,837.95 | $10,704.29 | $16,407.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $14,165.76 / $18,290.37
| Facility | | $6,965.00 | $14,165.76 | $18,290.37 |