- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,546.21 / $7,674.75 / $13,505.30
| Facility | | $4,546.21 | $7,674.75 | $13,505.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,777.87 / $3,777.87 / $4,024.66
| Facility | | $3,777.87 | $3,777.87 | $4,024.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,248.43 / $6,322.04 / $10,314.10
| Facility | | $4,248.43 | $6,322.04 | $10,314.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,135.49 / $7,074.25 / $10,183.68
| Facility | | $4,135.49 | $7,074.25 | $10,183.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,500.80 / $14,500.80 / $17,017.91
| Facility | | $14,500.80 | $14,500.80 | $17,017.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $6,688.48 / $9,553.73
| Facility | | $1,787.00 | $6,688.48 | $9,553.73 |