- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,377.30 / $12,295.20 / $19,796.80
| Facility | | $5,377.30 | $12,295.20 | $19,796.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,034.57 / $17,445.40
| Facility | | $1,474.01 | $5,034.57 | $17,445.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,656.00 / $12,176.62 / $18,211.25
| Facility | | $8,656.00 | $12,176.62 | $18,211.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,779.70 / $10,782.20 / $22,643.95
| Facility | | $7,779.70 | $10,782.20 | $22,643.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,870.26 / $10,484.70 / $19,439.03
| Facility | | $6,870.26 | $10,484.70 | $19,439.03 |