- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.82 / $10,880.30 / $15,405.40
| Facility | | $5,939.82 | $10,880.30 | $15,405.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,927.15 / $11,927.15 / $11,927.15
| Facility | | $11,927.15 | $11,927.15 | $11,927.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,623.70 / $10,671.18 / $17,102.18
| Facility | | $6,623.70 | $10,671.18 | $17,102.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,175.62 / $9,787.42 / $17,413.38
| Facility | | $6,175.62 | $9,787.42 | $17,413.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,584.93 / $9,234.42 / $20,591.34
| Facility | | $4,584.93 | $9,234.42 | $20,591.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $9,033.25 / $18,298.55
| Facility | | $3,308.00 | $9,033.25 | $18,298.55 |