- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,351.60 / $9,949.94 / $16,020.70
| Facility | | $4,351.60 | $9,949.94 | $16,020.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,526.78 / $7,526.78 / $7,526.78
| Facility | | $7,526.78 | $7,526.78 | $7,526.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,930.56 / $13,600.56
| Facility | | $1,474.01 | $5,930.56 | $13,600.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,202.47 / $10,403.29 / $14,737.52
| Facility | | $7,202.47 | $10,403.29 | $14,737.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,295.75 / $8,725.53 / $18,324.70
| Facility | | $6,295.75 | $8,725.53 | $18,324.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,911.06 / $8,647.20 / $15,731.11
| Facility | | $5,911.06 | $8,647.20 | $15,731.11 |