- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,949.59 / $13,603.70 / $21,903.80
| Facility | | $5,949.59 | $13,603.70 | $21,903.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,259.81 / $10,259.81 / $10,259.81
| Facility | | $10,259.81 | $10,259.81 | $10,259.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $7,161.21 / $18,677.65
| Facility | | $1,474.01 | $7,161.21 | $18,677.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,847.36 / $14,223.58 / $20,149.41
| Facility | | $9,847.36 | $14,223.58 | $20,149.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,607.67 / $11,929.71 / $25,053.87
| Facility | | $8,607.67 | $11,929.71 | $25,053.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,081.71 / $11,929.71 / $25,377.36
| Facility | | $8,081.71 | $11,929.71 | $25,377.36 |