- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,756.54 / $13,162.30 / $21,193.10
| Facility | | $5,756.54 | $13,162.30 | $21,193.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,777.07 / $11,777.07 / $11,777.07
| Facility | | $11,777.07 | $11,777.07 | $11,777.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,880.25 / $18,441.78
| Facility | | $1,474.01 | $6,880.25 | $18,441.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,527.85 / $13,762.08 / $19,495.64
| Facility | | $9,527.85 | $13,762.08 | $19,495.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,328.37 / $11,542.64 / $24,240.96
| Facility | | $8,328.37 | $11,542.64 | $24,240.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,819.49 / $11,542.64 / $24,553.96
| Facility | | $7,819.49 | $11,542.64 | $24,553.96 |