- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,193.04 / $8,766.70 / $15,426.90
| Facility | | $5,193.04 | $8,766.70 | $15,426.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,524.06 / $8,943.41 / $11,136.51
| Facility | | $4,524.06 | $8,943.41 | $11,136.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,443.47 / $6,423.35 / $10,468.20
| Facility | | $4,443.47 | $6,423.35 | $10,468.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,723.88 / $8,080.77 / $11,632.61
| Facility | | $4,723.88 | $8,080.77 | $11,632.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,300.15 / $16,300.15 / $19,129.61
| Facility | | $16,300.15 | $16,300.15 | $19,129.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $7,640.11 / $10,913.03
| Facility | | $1,787.00 | $7,640.11 | $10,913.03 |