- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,580.25 / $9,649.62 / $16,020.70
| Facility | | $6,580.25 | $9,649.62 | $16,020.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,650.03 / $7,212.00 / $12,724.93
| Facility | | $4,650.03 | $7,212.00 | $12,724.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,545.22 / $8,307.06 / $14,072.34
| Facility | | $5,545.22 | $8,307.06 | $14,072.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.67 / $10,292.44 / $14,799.27
| Facility | | $8,317.67 | $10,292.44 | $14,799.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,170.63 / $10,332.98 / $24,796.03
| Facility | | $5,170.63 | $10,332.98 | $24,796.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,228.12 / $9,474.23 / $13,688.51
| Facility | | $6,228.12 | $9,474.23 | $13,688.51 |